Surgical Treatment of Gastroesophageal Reflux Disease
Abstract
ABSTRACT
Background: Gastroesophageal reflux disease (GERD) is defined as symptoms or mucosal damage produced by the abnormal reflux of gastric content into the esophagus, affecting 17-40% of North Americans, and it is increasing in incidence. Its complicationBarrett's esophagus is premalignant.
Objective: To assess the role of surgery in GERD patients.
Methods: Eighty patients selected for surgical treatment of GERD out of 310 patients suffering of GERD during the period between May 1990 and April 2010, in Al-Rasheed Military Hospital, Baghdad Teaching Hospital and private hospitals, with post-operative follow up clinically, radiologically and endoscopically for a period of 18-132 months and mean of 62.45 ± 31.284 months. Hospital stay was 3-6 days and mean of 4.56 ± 0.992 days.
Results: Sixty two patients out of 80 patients were males (77.5%) and eighteen were females (22.5%) and male/female ratio was 3.4:1. Age range from one to 77 years old and mean age was 39.6 ± 15.1 years. Forty four patients (55%) were smokers. Twenty nine patients (36.25%) had history of alcohol consumption. Symptoms of heart burn were present in 72 patients (91%). Surgical treatments were done as follows: antireflux procedure was done in 70 out of 80 patients (87.5%). Teropexy was added in the last 12 patients for reinforcement of antireflux mechanism. Thirty patients (those with GERD with or without hiatal hernia with no precipitating disease), antireflux procedure alone was done. Twenty four patients (those with GERD with associated duodenal ulceration and gastric outlet obstruction) posterior truncal vagotomy, anterior gastric seromyotomy and Finney's pyloroplasty were added to the antireflux procedure. Twenty six patients (those with GERD with duodenal ulcer with no gastric outlet obstruction), sixteen of them only anterior gastric seromyotomy and posterior truncal vagotomy were added to the antireflux procedure, the remaining 10 patients anterior gastric seromyotomy and posterior truncal vagotomy were done without antireflux procedure. The results were successful in 76 (95%) patients.
Conclusions: Surgical remedy of GERD and its precipitating disease is the only available cure with very satisfactory result. Too many physicians don't view GERD as a surgical condition and still fail to give patients the choice that they deserve
Copyright (c) 201 Iraqi Medical Journal
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Share — copy and redistribute the material in any medium or format
Under the following terms:
-
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
-
NonCommercial — You may not use the material for commercial purposes.
-
NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
