Selection of patients for laparoscopic antireflux surgery.
Since the first laparoscopic fundoplication was performed, the frequency of antireflux surgery has increased rapidly with some centers now having an experience of about 1,000 procedures. The question arises whether this increase is due to a change in indications for the surgical treatment of gastrointestinal reflux disease (GERD) despite the simultaneous appearance of powerful antisecretory medications. Adequate knowledge of the pathophysiology of GERD is necessary in order to establish selection criteria for patients suitable for laparoscopic antireflux surgery. In this article, we review the epidemiology and pathophysiology, and provide a rationale for medical and surgical treatment. We also offer an approach to patient selection for antireflux surgery.
Surgical Department, Kaiserin-Elisabeth-Spital, Vienna, Austria.
K
K
Glaser
G J
GJ
Wetscher
A
A
Klingler
P J
PJ
Klingler
B
B
Eltschka
C
C
Hollinsky
S R
SR
Achem
R A
RA
Hinder
D000818:Animals; D001471:Barrett Esophagus / Q000150:complications / Q000601:surgery; D016099:Endoscopy, Gastrointestinal; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D005769:Gastrointestinal Motility; D006551:Hernia, Hiatal / Q000503:physiopathology; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D010535:Laparoscopy; D018579:Patient Selection; D019518:Postprandial Period / Q000502:physiology
D006635:Histamine H2 Antagonists