title: [Indications for antireflux surgery: a clinical experience and review of the literature].
abstract: Antireflux laparoscopic surgery has excellent results in terms of improvement of symptoms, esophagitis, gastroesophageal sphincter competence and abnormal acid reflux. Indications for surgery are well established, however some of these are controversial. This is a review of the present indications for surgery in gastroesophageal reflux. The surgical indication should be the result of a complex clinical and laboratory work up. Patients with a clear cut surgical indication should be differentiated from those with doubtful indications, that require further analysis and those that are bad candidates for surgery. Young patients with macroscopic esophagitis, an incompetent sphincter, abnormal acid reflux test, that have a partial or negative response to treatment with proton pump inhibitors are those with the best surgical results. Bad candidates are patients with a psychiatric background, with atypical symptoms and those with a normal acid reflux test. In our experience with 935 patients, only 23% had a surgical indication.
authors.affiliation: Departamento de Cirugía, Hospital Clínico de la Universidad de Chile, Santiago, Chile. ibraghet@redclinicauchile.cl
authors.forename: Italo
authors.initials: I
authors.lastname: Braghetto
authors.forename: Owen
authors.initials: O
authors.lastname: Korn
authors.forename: Héctor
authors.initials: H
authors.lastname: Valladares
authors.forename: Johanna
authors.initials: J
authors.lastname: Silva
authors.forename: Verónica
authors.initials: V
authors.lastname: Azabache
mesh_terms: D017558:Elective Surgical Procedures; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D018579:Patient Selection; D011184:Postoperative Period