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Anti-Reflux Procedures in Australia, 2000/1 to 2023/4: Increasing Rates in Females and in Older Patients
Christopher Goubar1, Thomas Goubar1,2, Douglas Fenton-Lee1,2
1School of Medicine, Sydney, The University of Notre Dame, Darlinghurst, New South Wales, Australia.
ANZ Journal of Surgery
|April 16, 2026
Summary
Surgical management of gastro-oesophageal reflux disease (GORD) in Australia has shifted significantly, with paraoesophageal hiatal hernia (POH) repair increasing and isolated fundoplasty decreasing. Trends show higher rates in females and older individuals.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Public Health
Background:
- Gastro-oesophageal reflux disease (GORD) affects many, with surgery offering relief for refractory symptoms.
- Surgical intervention for GORD varies in uptake and effectiveness across patient subgroups.
- Understanding long-term national trends is crucial for clinical practice and service planning in GORD management.
Purpose of the Study:
- To analyze national trends in anti-reflux procedures and paraoesophageal hiatal hernia (POH) repair in Australia.
- To examine age-adjusted and age-sex-specific rates of GORD surgeries from 2000 to 2024.
- To identify shifts in surgical management patterns for GORD over two decades.
Main Methods:
- Population-based study utilizing Australian national data from 2000 to 2024.
- Analysis of anti-reflux procedures, POH repair, and gastroscopies in adults (≥18 years).
- Calculation of age-standardised and age-sex-specific rates to assess trends.
Main Results:
- Rates for POH repair and overall reflux surgery increased by 245.6% (p < 0.001).
- POH repair constituted 57.9% of procedures, with a dramatic 4924.7% increase.
- Isolated fundoplasty declined by 65.9%, while cardiopexy increased by 3395.8%.
Conclusions:
- A significant shift in GORD surgical management occurred, favoring POH repair over isolated fundoplasty.
- Females and older individuals exhibited higher rates of GORD surgery, with marked increases in these demographics.
- Findings highlight evolving operative patterns and necessitate research into sex and age disparities for improved clinical decision-making and patient outcomes.
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