[Surgical management of reflux disease]

Surgical therapy of reflux disease aspires to beneficially influence pathogenetic principles. Gastric-proximal vagotomy results in lowered aggressivity of reflux, the Roux-Y-procedure in elimination of bile reflux. Classical antireflux procedures, in particular valvuloplastic types, reduce or eliminate gastroesophageal reflux altogether. The procedure selected among these is to be based on the grade of reflux. Whereas in reflux of more benign character selection of procedures is among the less invasive types, reflux disease classified in stages III and IV requires selection of procedures with known and proven effectivity (valvuloplastic).