Abstract

When is it necessary to consider surgical treatment for gastroesophageal reflux disease?

Gastroesophageal reflux disease (GERD) is a common health problem that is becoming increasingly more prevalent. It is estimated to affect 8.8% – 25.9% of the population in Europe. The most common symptoms are heartburn, regurgitation, cough and chest pain. Proton pump inhibitors (PPIs) are the most common treatment for GERD as they reduce or eliminate the symptoms. Unfortunately, GERD symptoms tend to recur after discontinuing PPIs in more than 70% of cases, and therefore patients need to take medications on a long-term basis. Currently, there is no definitive ‘gold standard’ for diagnosing GERD. In some cases, a ‘typical’ history is sufficient to make the diagnosis based on the presence of heartburn that disappears with the use of PPIs and returns after PPIs are discontinued. When medical treatment fails, surgery may be necessary. This is often the case for noncompliant patients, those who wish to discontinue long-term treatment, or those who have GERD-related complications. Several types of anti-reflux treatment options are available, including conservative treatment with PPIs, surgery and endoscopic treatment. Despite the availability of a wide range of methods, laparoscopic fundoplication is currently the most effective surgical treatment for severe GERD, with a high rate of patient satisfaction.

Piśmiennictwo

1. Bowditch HI. A Treatise on Diaphragmatic Hernia. Buffalo: Jewett Thomas, 1853

2. Katayama RC, Herbella FAM, Schlottmann F, et al. Lessons Learned from the History of Fundoplication. SN Compr Clin Med. 2020;2:775-81. https://doi.org/10.1007/s42399-020-00311-2

3. Nissen R. Eine einfache Operation zur Beeinflussung der Refluxoesophagitis (A Simple Operation for Control of Reflux Esophagitis). Schweizerische Medizinische Wochenschrift (in German) 1956;86(Supl 20):590-2

4. GBD 2017 Gastro-oesophageal Reflux Disease Collaborators. The global, regional, and national burden of gastro-oesophageal reflux disease in 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet Gastroenterol Hepatol 2020;5(6):561-81. doi: 10.1016/S2468-1253(19)30408-X

5. Dean BB, Gano AD Jr, Knight K, et al. Effectiveness of proton pump inhibitors in nonerosive reflux disease. Clin Gastroenterol Hepatol 2004;2(8):656-64. doi: 10.1016/s1542-3565(04)00288-5

6. Numans ME, Lau J, de Wit NJ, et al. Short-term treatment with proton-pump inhibitors as a test for gastroesophageal reflux disease: a meta-analysis of diagnostic test characteristics. Ann Intern Med 2004;140(7):518-27. doi: 10.7326/0003-4819-140-7-200404060-00011

7. Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon Consensus. Gut 2018 Jul;67(7):1351-62. doi: 10.1136/gutjnl-2017-314722

8. Gyawali CP, Carlson DA, Chen JW, et al. ACG Clinical Guidelines: Clinical Use of Esophageal Physiologic Testing. Am J Gastroenterol 2020;115(9):1412-28. doi: 10.14309/ajg.0000000000000734

9. Pauwels A, Boecxstaens V, Andrews CN, et al. How to select patients for antireflux surgery? The ICARUS guidelines (international consensus regarding preoperative examinations and clinical characteristics assessment to select adult patients for antireflux surgery). Gut 2019;68(11):1928-41

10. Katz PO, Dunbar KB, Schnoll-Sussman FH, et al. ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol 2022;117(1):27-56. doi: 10.14309/ajg.0000000000001538

11. Khan M, Santana J, Donnellan C, et al. Medical treatments in the short term management of reflux oesophagitis. Cochrane Database Syst Rev 2007;2:CD003244. doi: 10.1002/14651858.CD003244.pub2. Update in: Cochrane Database Syst Rev 2011;2:CD003244

12. Paudel Y, Najam B, Desai HN, et al. Use of Proton Pump Inhibitors and Risk of Fracture in Adults: A Review of Literature. Cureus 2023;15(12):e49872. doi: 10.7759/cureus.49872

13. Thurber KM, Otto AO, Stricker SL. Proton pump inhibitors: Understanding the associated risks and benefits of long-term use. Am J Health Syst Pharm 2023;80(8):487-94. doi: 10.1093/ajhp/zxad009

14. Dunbar KB, Agoston AT, Odze RD, et al. Association of Acute Gastroesophageal Reflux Disease With Esophageal Histologic Changes. JAMA 2016;315(19):2104-12. doi: 10.1001/jama.2016.5657

15. Spechler SJ. The Durability of Antireflux Surgery. JAMA 2017;318(10):913-15. doi: 10.1001/jama.2017.11461

16. Dallemagne B, Weerts JM, Jehaes C, et al. Laparoscopic Nissen fundoplication: preliminary report. Surg Laparosc Endosc 1991;1(3):138-43

17. Gehwolf P, Agerer T, Stacul N, et al. Lap. Nissen fundoplication leads to better respiratory symptom control than Toupet in the long term of 20 years. Langenbecks Arch Surg 2023;408:372. https://doi.org/10.1007/s00423-023-03108-8

18. Skubleny D, Switzer NJ, Dang J, et al. LINX® magnetic esophageal sphincter augmentation versus Nissen fundoplication for gastroesophageal reflux disease: a systematic review and meta-analysis. Surg Endosc 2017;31(8):3078-84. doi: 10.1007/s00464-016-5370-3

19. Slater BJ, Collings A, Dirks R, et al. Multi-society consensus conference and guideline on the treatment of gastroesophageal reflux disease (GERD). Surg Endosc 2023;37(2):781-806. doi: 10.1007/s00464-022-09817-3

20. Sui X, Gao X, Zhang L, et al. Clinical efficacy of endoscopic antireflux mucosectomy vs. Stretta radiofrequency in the treatment of gastroesophageal reflux disease: a retrospective, single-center cohort study. Ann Transl Med 2022;10(12):660. doi: 10.21037/atm-22-2071

21. Ihde GM. The evolution of TIF: transoral incisionless fundoplication. Therap Adv Gastroenterol 2020;13:1756284820924206. doi: 10.1177/1756284820924206

22. Janu P, Shughoury AB, Venkat K, et al. Laparoscopic Hiatal Hernia Repair Followed by Transoral Incisionless Fundoplication With EsophyX Device (HH + TIF): Efficacy and Safety in Two Community Hospitals. Surg Innov 2019;26(6):675-86

23. Aslam N, Telese A, Sehgal V, et al. Minimally invasive endoscopic therapies for gastro-oesophageal reflux disease. Frontline Gastroenterol 2023;14(3):249-57. doi: 10.1136/flgastro-2022-102343

24. Yoo IK, Ko WJ, Kim HS, et al. Anti-reflux mucosectomy using a cap-assisted endoscopic mucosal resection method for refractory gastroesophageal disease: a prospective feasibility study. Surg Endosc 2020;34(3):1124-31

25. Liu S, Chai N, Zhai Y, et al. New treatment method for refractory gastroesophageal reflux disease (GERD): C-BLART (clip band ligation anti-reflux therapy)-a short-term study. Surg Endosc 2020;34(10):4516-24

26. Paireder M, Kristo I, Asari R, et al. Electrical lower esophageal sphincter augmentation in patients with GERD and severe ineffective esophageal motility-a safety and efficacy study. Surg Endosc 2019;33(11):3623-8

27. Prassas D, Krieg A, Rolfs TM, et al. Long-term outcome of laparoscopic Nissen fundoplication in a regional hospital setting. Int J Surg 2017;46:75-8. doi: 10.1016/j.ijsu.2017.08.580

Do góry