| Theme |
Recent Advances in Diagnosis and Treatment of Reflux Esophagitis |
| Title |
Surgical Treatment : Indications and Clinical Results of Laparoscopic Antireflux Surgery |
| Author |
Hideyuki Kashiwagi |
Department of Surgery, Kashiwa Hospital, Jikei University School of Medicine |
| Author |
Nobuo Omura |
Department of Surgery, Jikei University School of Medicine |
| Author |
Satoru Yanagisawa |
Department of Surgery, Kashiwa Hospital, Jikei University School of Medicine |
| Author |
Yoshio Ishibashi |
Department of Surgery, Jikei University School of Medicine |
| Author |
Yutaka Suzuki |
Department of Surgery, Jikei University School of Medicine |
| Author |
Katsuhiko Yanaga |
Department of Surgery, Jikei University School of Medicine |
| [ Summary ] |
The number of surgical treatments available for gastroesophageal reflux disease and hiatal hernia have been increased by the introduction of laparoscopic surgery. Laparoscopic antireflux surgery is at least as safe and as effective as its open counterpart with reduced morbidity and shortened postoperative stays. It is currently suggested as the gold standard for surgical treatment of gastroesophageal reflux disease. Surgical indications are for patients who do not respond to proton pump inhibitors (PPI). The indications are for patients who have demonstrated the long term need for medical therapy. Young patients, in particular, with documented chronic reflux disease and noncompliant patients are excellent candidates for surgery. Esophageal pH monitoring and PPI challenging test are useful to distinguish the surgical indications for patients with respiratory symptoms or atypical symptoms. It is a safe treatment, but skillful surgical techniques are important to prevent operative and postoperative complications. Collis-Nissen procedures for shortening the esophagus and reoperations, after laparoscopic antireflux surgery, have been recently performed laparoscopically. |