Gastroesophageal reflux disease (GERD) is one of the most frequent upper gastrointestinal disorders worldwide. It is defined as a chronic condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. A review of literature has been performed to evaluate the adequate preoperative diagnostic workup, indications to anti-reflux surgery, and surgical outcomes. To establish a correct indication, objective diagnosis of GERD with endoscopy, 24-hour impedancepH monitoring and esophageal manometry is needed. A careful preoperative selection of patients is the first critical step to reduce the risk of side effects and failure of laparoscopic anti-reflux surgery (LARS). Laparoscopic 360° fundoplication (LTF) is the gold standard surgical treatment for GERD. Relief of heartburn and regurgitation is achieved by 80–90% of patients at 10 years follow-up. Partial fundoplications (anterior and posterior) guarantee similar outcomes in terms of symptom control with a lower risk of postoperative dysphagia. However, at the long-term follow-up, partial fundoplications are associated with an increased number of recurrent reflux episodes at 24-hour pH monitoring when compared to 360° fundoplication. More studies are needed to compare the different types of fundoplication in the long-term follow-up period.

Laparoscopic surgery for gastroesophageal reflux disease: Nissen, Toupet or anterior fundoplication

Morino, Mario
First
;
Ugliono, Elettra;Allaix, Marco Ettore;Rebecchi, Fabrizio
Last
2019-01-01

Abstract

Gastroesophageal reflux disease (GERD) is one of the most frequent upper gastrointestinal disorders worldwide. It is defined as a chronic condition which develops when the reflux of stomach contents causes troublesome symptoms and/or complications. A review of literature has been performed to evaluate the adequate preoperative diagnostic workup, indications to anti-reflux surgery, and surgical outcomes. To establish a correct indication, objective diagnosis of GERD with endoscopy, 24-hour impedancepH monitoring and esophageal manometry is needed. A careful preoperative selection of patients is the first critical step to reduce the risk of side effects and failure of laparoscopic anti-reflux surgery (LARS). Laparoscopic 360° fundoplication (LTF) is the gold standard surgical treatment for GERD. Relief of heartburn and regurgitation is achieved by 80–90% of patients at 10 years follow-up. Partial fundoplications (anterior and posterior) guarantee similar outcomes in terms of symptom control with a lower risk of postoperative dysphagia. However, at the long-term follow-up, partial fundoplications are associated with an increased number of recurrent reflux episodes at 24-hour pH monitoring when compared to 360° fundoplication. More studies are needed to compare the different types of fundoplication in the long-term follow-up period.
2019
4
1
9
Gastroesophageal reflux disease (GERD); laparoscopic 360 degrees fundoplication (LTF); partial anterior fundoplication; partial posterior fundoplication; 24-hour ambulatory pH-monitoring
Morino, Mario; Ugliono, Elettra; Allaix, Marco Ettore; Rebecchi, Fabrizio
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/1712291
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