Antireflux surgery in the setting of lung transplantation: strategies for treating gastroesophageal reflux disease in a high-risk population.
In lung transplant recipients, GERD is associated with increased incidence of acute rejection, earlier onset of chronic rejection, and higher mortality. Surgical treatment of GERD in lung recipients seems to prevent early allograft dysfunction and improve overall survival. A total (360 degrees) fundoplication is shown to be a safe and effective method for treating GERD in lung transplant recipients and is the authors' procedure of choice, in most cases, for this high-risk patient population. The principal goal should be to minimize reflux of enteric contents that may lead to micro- or macroaspiration events in this complicated group of patients. Perioperative care should involve a multidisciplinary approach, including physicians and other health care providers familiar with the complexities of lung transplant recipients.
Hartwig
Matthew G
MG
Division of Thoracic Surgery, Duke University Medical Center, Department of Surgery, Box 3864, Durham, NC 27710, USA.
Appel
James Z
JZ
Davis
R Duane
RD
D001989:Bronchiolitis Obliterans / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D018579:Patient Selection; D019990:Perioperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome