[Surgical treatment for GERD].
Surgical treatment for GERD is still indicated in a few cases. In particular, patients who resist PPI medical treatment, patients who do not comply well with medication, and young patients with strong subjective symptoms are candidates for surgical treatment. Others include patients with free reflux, with short esophagus, with esophageal stenosis, and with respiratory or oto-laryngological complications. The choice of operative method depends on the disease state and stage of GERD. The first choice of treatment in most cases is laparoscopic Nissen technique, and the second choice is laparoscopic Toupet method. The problem for surgeons is the need for extremely delicate technique in the reconstructive parts of the procedure in cases with a high degree of fundoplication and functional disorder. We adopted an operative technique that combines SPV, Toupet method and Hill method; we have found a good rate of patient acclimatization and high postoperative satisfaction. Time is still required, however, to bring laparoscopic surgery to the same level as open surgery.
Makuuchi
Hiroyasu
H
Department of Digestive Surgery, Tokai University School of Medicine.
Shimada
Hideo
H
Chino
Osamu
O
D003679:Deglutition; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004947:Esophagus / Q000502:physiology / Q000503:physiopathology / Q000601:surgery; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*