title: A three-year experience of the Referral Center for Surgical Treatment of Gastroesophageal Reflux Disease.
abstract: OBJECTIVE
  Gastro-esophageal reflux disease (GERD) rapresents the fastest growing disease affecting the alimentary and breathing apparatus. Incidence of esophageal adenocarcinoma with Barrett Esophagus (BE) imposes a decision about therapy management.
  
  
  METHODS
  Between January 2006 to December 2009, 3 653 patients were subjected to our observation; 2 095 patients underwent endoscopy (57.4%), of these 598 underwent twenty-four hours pH-Metry (16.3%); 1 558 patients (42.6%) had clinical consult.
  
  
  RESULTS
  A total of 1 255/2 095 referred typical symptoms (60%), 644 patients typical and atypical symptoms (30.7%), 96 patients atypical symptoms (4.6%); 4.7% had dysfagia and cramps; 1 897 patients (90.5%) had Los Angeles A esophagitis, 62 Los Angeles B (2.96%), 6 had Shatzki Ring (0.3%). NERD in 26 patients (1.24%); 3.4% had Hp Gastritis; 33 had BE (1.6%), 10 intestinalized type (30.3%), 23 gatric type (69.7%). Eighty-five/2 095 patients (4%, 36 M and 49 F, m.a. 42.5 years, range 20-72) underwent laparoscopic Nissen-Rossetti Fundoplication (4%), 69 with preoperative typical symptoms (81%), 11 typical and atypical symptoms (13%), 5 atypical symptoms (6%). Twenty-three had BE (27%, 9 intestinal metaplasia, 3 Long and 6 Short Barrett, 14 Gastric metaplasia); 61 with Los Angeles A esophagitis (98.3%), 1 with Shatzki Ring (1.7%). PH-Metries were positive.
  
  
  CONCLUSIONS
  GERD requires specialistic and qualified centers.
authors: Department of Surgery, F. Durante,Umberto I Policlinic, La Sapienza Universit, Rome, Italy.
authors: S
authors: S
authors: Marano
authors: S
authors: S
authors: Mattacchione
authors: G
authors: G
authors: Paltrinieri
authors: L
authors: L
authors: Palombi
authors: V
authors: V
authors: Mingarelli
authors: F
authors: F
authors: Tosato