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EAES recommendations for the management of gastroesophageal reflux disease

  • Consensus Statement
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Gastroesophageal reflux disease (GERD) is one of the most frequent benign disorders of the upper gastrointestinal tract. Management of GERD has always been controversial since modern medical therapy is very effective, but laparoscopic fundoplication is one of the few procedures that were quickly adapted to the minimal access technique. The purpose of this project was to analyze the current knowledge on GERD in regard to its pathophysiology, diagnostic assessment, medical therapy, and surgical therapy, and special circumstances such as GERD in children, Barrett’s esophagus, and enteroesophageal and duodenogastroesophageal reflux.

Methods

The European Association of Endoscopic Surgery (EAES) has tasked a group of experts, based on their clinical and scientific expertise in the field of GERD, to establish current guidelines in a consensus development conference. The expert panel was constituted in May 2012 and met in September 2012 and January 2013, followed by a Delphi process. Critical appraisal of the literature was accomplished. All articles were reviewed and classified according to the hierarchy of level of evidence and summarized in statements and recommendations, which were presented to the scientific community during the EAES yearly conference in a plenary session in Vienna 2013. A second Delphi process followed discussion in the plenary session.

Results

Recommendations for pathophysiologic and epidemiologic considerations, symptom evaluation, diagnostic workup, medical therapy, and surgical therapy are presented. Diagnostic evaluation and adequate selection of patients are the most important features for success of the current management of GERD. Laparoscopic fundoplication is the most important therapeutic technique for the success of surgical therapy of GERD.

Conclusions

Since the background of GERD is multifactorial, the management of this disease requires a complex approach in diagnostic workup as well as for medical and surgical treatment. Laparoscopic fundoplication in well-selected patients is a successful therapeutic option.

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Acknowledgments

The panelists express their gratitude to the EAES and the scientific community during the 21st EAES Congress 2013 in Vienna for their support of this work.

Disclosures

Karl Hermann Fuchs, Benjamin Babic, Wolfram Breithaupt, Bernard Dallemagne, Abe Fingerhut, Edgar Furnee, Frank Granderath, Peter Horvath, Peter Kardos, Rudolph Pointner, Edoardo Savarino, Maud Van Herwaarden-Lindeboom, and Giovanni Zaninotto have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, AGAPLESION Markus Krankenhaus, Wilhelm-Epstein-Str. 4, 60431, Frankfurt, Germany

    Karl Hermann Fuchs, Benjamin Babic & Wolfram Breithaupt

  2. IRCAD Institute, Strasbourg, France

    Bernard Dallemagne

  3. Poissy, France

    Abe Fingerhut

  4. University Medical Center Utrecht, Utrecht, The Netherlands

    Edgar Furnee

  5. Department of Surgery, Krankenhaus Neuwerk, Mönchengladbach, Germany

    Frank Granderath

  6. Department of Surgery, University of Pecs, Pecs, Hungary

    Peter Horvath

  7. Group Practice & Respiratory Unit, Maingau Krankenhaus, Frankfurt, Germany

    Peter Kardos

  8. Department of Surgery, Krankenhaus Zell am See, Zell am See, Austria

    Rudolph Pointner

  9. Department of Gastroenterology, University of Padua, Padua, Italy

    Edoardo Savarino

  10. Department of Pediatric Surgery, University of Utrecht, Utrecht, The Netherlands

    Maud Van Herwaarden-Lindeboom

  11. Department of Surgery, Imperial College, London, UK

    Giovanni Zaninotto

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  1. Karl Hermann Fuchs
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Correspondence to Karl Hermann Fuchs.

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Fuchs, K.H., Babic, B., Breithaupt, W. et al. EAES recommendations for the management of gastroesophageal reflux disease. Surg Endosc 28, 1753–1773 (2014). https://doi.org/10.1007/s00464-014-3431-z

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