Surgical treatment of gastroesophageal reflux standard is fundoplication. Goal of this process is twofold:
* LES pressure, therefore, prevent acid backup (back).
* Any repair, hiatal hernia.
There are two main methods:
* Open fundoplication (a minimally invasive technique).
* Fundoplication.
Overall, the overall long-term interests, these procedures are similar. A number of studies have pointed out that more than 90 percent of patients are free of heartburn after surgery, and are not satisfied with their choice, even after five years. The waiver of gastroesophageal reflux caused coughing and other symptoms of respiratory tract infection, as many as 85% of patients. (GERD and related to asthma patients, however, is still not clear.), Which can enhance gastric emptying and improve peristalsis, in about half of patients. (It actually may have abnormal peristalsis, about 14% of the patients, although in this case, the problem does not seem very significant).
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Nevertheless, it still considerable restrictions and postoperative problems. For example, the results of the 2003 survey, 18% of the patients still need anti-gastroesophageal reflux drugs, and 38 per cent, there will be new symptoms (such as gas, bloating, trouble swallowing), most of which occurred more than a year after the surgery. Other studies have reported similar results. In addition, the fundoplication no cure for GERD. Finally, the evidence - in the 2002 Swedish study - strongly implies that the procedure does not reduce the risk for esophageal cancer in high-risk patients, such as those with Barrett esophagus.
Candidates. Fundoplication recommend patients, the conditions include one or more of the following elements:
* Esophagitis (inflammation of the esophagus).
* Symptoms persist or recurrent, although anti-reflux medication.
* Stenosis.
* Failure to obtain or maintain body weight (children).
Fundoplication has been little help patients with impaired gastric motility (spontaneous inability to move muscles)