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Laparoscopic antireflux surgery

W S Richardson¹, J G Hunter, J P Waring

¹Department of Medicine and Surgery, Emory University School of Medicine, Atlanta, GA, USA.

Seminars in Gastrointestinal Disease

|April 1, 1997

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Proton pump inhibitors and laparoscopic antireflux surgery offer effective management for chronic gastroesophageal reflux disease. Careful patient selection and thorough evaluation are key to successful surgical outcomes.

Area of Science:

Gastroenterology
Surgical Management
Gastroesophageal Reflux Disease

Background:

Proton pump inhibitors (PPIs) provide effective medical treatment for most chronic gastroesophageal reflux disease (GERD) patients.
Laparoscopic antireflux surgery offers a medication-free option for select GERD patients, particularly those with treatment failure.
Factors influencing surgical decisions include patient age, medication costs, symptom type, and complications like Barrett's esophagus.

Purpose of the Study:

To review the current management strategies for chronic gastroesophageal reflux disease.
To outline the indications and preoperative evaluation for laparoscopic antireflux surgery.
To discuss the outcomes and key factors for successful antireflux surgery.

Main Methods:

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Review of current medical and surgical treatment options for GERD.

Description of diagnostic tools for preoperative evaluation, including endoscopy, manometry, and pH monitoring.

Discussion of factors influencing the decision-making process for antireflux surgery.

Main Results:

Proton pump inhibitors are highly effective for the majority of GERD patients.
Laparoscopic antireflux surgery is indicated for medical therapy failure and selected long-term PPI users.
Comprehensive preoperative evaluation is crucial for optimal surgical selection and outcomes.

Conclusions:

Laparoscopic antireflux surgery yields excellent results in properly selected patients.
Thorough patient evaluation, informed consent, and surgeon skill are paramount for successful antireflux surgery.
Antireflux surgery is a highly successful option for the majority of considered patients when these principles are followed.