Gastroesophageal reflux disease surgery: Difference between revisions

Jump to navigation Jump to search
← Older editNewer edit →
VisualWikitext
Anthony Gallo (talk | contribs)
Bureaucrats, bureaucrats, nocaptcha, Administrators
6,611 edits
m Categories
Aelsaiey (talk | contribs)
nocaptcha, smwadministrator, Administrators
4,616 edits
Line 6: Line 6:


==Surgery==
==Surgery==
===Surgical treatment===
* Surgery is not the first line of treatment of GERD. However, it can be as effective as the medical treatment in some cases of GERD.  
The standard surgical treatment, sometimes preferred over longtime use of medication, is the ''[[Nissen fundoplication]]''. The upper part of the stomach is wrapped around the LES to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia. The procedure is often done [[Laparoscopic surgery|laparoscopically]].<ref name=Abbas_2004>{{cite journal |author=Abbas A, Deschamps C, Cassivi SD, et al. |title=The role of laparoscopic fundoplication in Barrett’s esophagus |journal=Annals of Thoracic Surgery |volume=77 |issue=2 |pages=393-396 |year=2004 |pmid=14759403}}</ref>
* Surgery is very effective in cases who present with typical symptoms of GERD which are heart burn and regurgitation and patients who have ambulatory pH studies with good symptom correlation.<ref name="pmid17970835">{{cite journal| author=Oelschlager BK, Quiroga E, Parra JD, Cahill M, Polissar N, Pellegrini CA| title=Long-term outcomes after laparoscopic antireflux surgery. | journal=Am J Gastroenterol | year= 2008 | volume= 103 | issue= 2 | pages= 280-7; quiz 288 | pmid=17970835 | doi=10.1111/j.1572-0241.2007.01606.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17970835  }}</ref>
 
* Surgery is recommended for treatment of GERD in the following cases:
An obsolete treatment is [[vagotomy]] ("highly selective vagotomy"), the surgical removal of [[vagus nerve]] branches that innervate the stomach lining. This treatment has been largely replaced by medication.
** Chronic GERD cases
===Endoluminal fundoplication===
** Patients who do not desire to continue the medical therapy
In June 2006 EndoGastric Solutions introduced [http://www.egseurope.eu EsophyX ELF] in the Europe Union as an alternative to surgical and pharmaceutical approaches for GERD treatment. EsophyX ELF is intended to deliver similar benefits as the time-proven laparoscopic fundoplication procedures, by reducing hiatal hernia, recreating the Angle of His, and creating a GastroEsophageal Valve (GEV). The key differences are that EsophyX ELF is an endoscopic non-invasive procedure that is performed transorally (through the mouth), does not require incisions, and does not dissect any part of the natural anatomy.
** Non-compliant medical therapy
 
** Side effects associated with the medical treatment
Previous endoluminal treatments focused predominantly on the LES. However, failure to effectively treat reflux long-term with endoluminal therapies that focused only on the Lower Esophageal Sphincter (LES) combined with the fact that surgical approaches like Nissen fundoplication recreate the GEV and have excellent long-term efficacy, has led to an awareness that the GEV is probably the most powerful component of the Anti-Reflux Barrier. The device has been designed to deploy multiple tissue fasteners to create a robust and durable valve and is intended to restore the geometry of the GastroEsophageal Junction and recreate the natural, unidirectional valve mechanism necessary to prevent GERD. [http://www.endogastricsolutions.com/index.php?src=news&submenu=News&refno=19 EsophyX ELF has recently been cleared by the US FDA] and is now available in the U.S.
** The presence of large hiatal hernia
** Complications associated with GERD like esophagitis 
*


==References==
==References==

Revision as of 18:17, 5 December 2017

Gastroesophageal reflux disease Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Gastroesophageal Reflux Disease from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Gastroesophageal reflux disease surgery On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Gastroesophageal reflux disease surgery

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Gastroesophageal reflux disease surgery

CDC on Gastroesophageal reflux disease surgery

Gastroesophageal reflux disease surgery in the news

Blogs on Gastroesophageal reflux disease surgery

Directions to Hospitals Treating Gastroesophageal reflux disease

Risk calculators and risk factors for Gastroesophageal reflux disease surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Surgery

  • Surgery is not the first line of treatment of GERD. However, it can be as effective as the medical treatment in some cases of GERD.
  • Surgery is very effective in cases who present with typical symptoms of GERD which are heart burn and regurgitation and patients who have ambulatory pH studies with good symptom correlation.[1]
  • Surgery is recommended for treatment of GERD in the following cases:
    • Chronic GERD cases
    • Patients who do not desire to continue the medical therapy
    • Non-compliant medical therapy
    • Side effects associated with the medical treatment
    • The presence of large hiatal hernia
    • Complications associated with GERD like esophagitis

References

  1. ↑ Oelschlager BK, Quiroga E, Parra JD, Cahill M, Polissar N, Pellegrini CA (2008). "Long-term outcomes after laparoscopic antireflux surgery". Am J Gastroenterol. 103 (2): 280–7, quiz 288. doi:10.1111/j.1572-0241.2007.01606.x. PMID 17970835.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Gastroesophageal_reflux_disease_surgery&oldid=1401716"