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A tailored approach to antireflux surgery
W K Kauer1, J H Peters, T R DeMeester
1Department of Surgery, University of Southern California School of Medicine, Los Angeles 90033-4612, USA.
The Journal of Thoracic and Cardiovascular Surgery
|July 1, 1995
Summary
Tailored surgical antireflux procedures effectively treated gastroesophageal reflux disease (GERD) symptoms like heartburn and regurgitation. Patient-specific surgical approaches led to high symptom cure rates and satisfaction.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Digestive System Diseases
Background:
- Gastroesophageal reflux disease (GERD) presents with significant symptoms like heartburn, regurgitation, and dysphagia.
- Surgical intervention is considered for GERD when medical management is insufficient.
Purpose of the Study:
- To evaluate the outcomes of tailored surgical antireflux procedures in patients with GERD.
- To assess the efficacy of patient-specific surgical strategies in managing GERD symptoms.
Main Methods:
- A 7-year study involving 104 patients undergoing tailored antireflux surgery.
- Preoperative evaluation included barium esophagography, endoscopy, pH monitoring, and motility studies.
- Surgical procedures were individualized based on patient's anatomy and function, including various Nissen fundoplications and Belsey procedures.
Main Results:
- High symptom cure rates were observed: 97% for heartburn, 91% for regurgitation, and 92% for dysphagia.
- 82% of patients were contacted for follow-up, with a median of 4 years.
- 98% reported symptom cure, and 93% expressed satisfaction with the surgical outcome.
Conclusions:
- Tailored surgical antireflux procedures demonstrate excellent efficacy in managing GERD.
- Individualized surgical treatment based on patient assessment is crucial for optimal outcomes in GERD management.
- Specific procedures, like transabdominal Nissen fundoplication, are recommended for early disease, while complex cases require customized open procedures.