| Theme | GERD in Clinical Practice 2018 -- Current Status and Issues | |
|---|---|---|
| Title | Surgical Treatment for GERD | |
| Publish Date | 2018/03 | |
| Author | Junya Oguma | Department of Gastroenterological Surgery, Tokai University School of Medicine |
| Author | Soji Ozawa | Department of Gastroenterological Surgery, Tokai University School of Medicine |
| Author | Akihito Kazuno | Department of Gastroenterological Surgery, Tokai University School of Medicine |
| Author | Miho Nitta | Department of Gastroenterological Surgery, Tokai University School of Medicine |
| Author | Yamato Ninomiya | Department of Gastroenterological Surgery, Tokai University School of Medicine |
| Author | Kentaro Yatabe | Department of Gastroenterological Surgery, Tokai University School of Medicine |
| [ Summary ] | Surgical treatment to prevent/control gastroesophageal reflux is often selected for patients with gastroesophageal reflux disease (GERD) who are refractory to medical treatment or present with concomitant severe hiatal hernia symptoms. Laparoscopic surgery using the Toupet fundoplication technique is the procedure most commonly performed in hospitals to treat these patients and involves rolling the fornix around the abdominal esophagus at an angle of 270 degrees. Recently, detailed evaluation of gastroesophageal reflux has been facilitated by the introduction of 24‒hour esophageal impedance and pH monitoring. Thus, it would be possible to establish more objective criteria to aid patient selection for the surgical management of GERD. Clinical trials to evaluate endoscopic treatment for the management of GERD are underway in Western countries, as well as in Japan. These are minimally invasive antireflux procedures, and their usefulness and long‒term outcomes need to be evaluated in the future. | |