[Gastroesophageal reflux disease -- current trends].
GERD has long been recognized as a significant public health concern in USA generating along the time, many disscusions between gastroenterologists and surgeons. Once antireflux barrier was identified, and mechanism of reflux established, GERD can be defined as the failure of the antireflux barrier (represented especially by the lower esophageal sphincter, by gastric empty disorders or failed esophageal peristalsis), allowing abnormal reflux of gastric contents into the esophagus. Positiv diagnosis is setting by the presence of documented esophageal mucosal injury (esophagitis) or excessive reflux during 24 hours intra-edophageal pH monitoring. Medical treatament is efficient in acid suppression, but does not address the mechanical etiology, is too expansive and affect the quality of life of pacients. Miniinvasive surgery was a boom in management of GERD, offering great sathysfaction to pacients, low costs and rapid social integration. We present in folwing pages the role of surgery in GERD, therapy GERD which occur 85-93% control of reflux simptomathology, providing data from the literature on the techniques used, their advantages and limitations.
Clinica de Chirurgie I, Institutul Oncologic Prof. dr. Alexandru Trestioreanu, Bucureşti, România.
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D000367:Age Factors; D050782:Esophageal pH Monitoring; D019317:Evidence-Based Medicine; D018662:Fundoplication / Q000639:trends*; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000639:trends*; D017060:Patient Satisfaction; D011788:Quality of Life; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome