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Anti-reflux Procedures and Cardioesophagomyotomy

  • Gianluigi Melotti
  • Vincenzo Trapani
  • Marzio Frazzoni
  • Michele Varoli
  • Micaela PiccoliEmail author
Part of the Updates in Surgery book series (UPDATESSURG)

Abstract

Currently, gastroesophageal reflux disease (GERD) is defined as a condition that develops when the reflux of gastric contents into the esophagus leads to troublesome symptoms and/or complications [1]. In Western countries, GERD is the most common chronic disease in the adult population with a 20% prevalence. The typical reflux syndrome includes heartburn and regurgitation. Barrett’s esophagus is the most dreaded complication of GERD, occurring in 2% of the general adult population: it predisposes sufferers to esophageal adenocarcinoma, the fastest growing cause of cancer mortality in Western countries [2]. No more than 20% of patients with typical reflux symptoms have erosions of the esophageal mucosa at endoscopic examination, i.e. have erosive reflux disease. The vast majority of patients with the typical reflux syndrome have normal endoscopic findings: those responding to proton pump inhibitor (PPI) therapy have nonerosive reflux disease whereas those with PPI-refractory typical symptoms should undergo 24 h impedance-pH monitoring to discriminate between PPI-refractory GERD and functional heartburn [3, 4]. PPIs provide rapid symptomatic relief in up to 80% of patients with the typical reflux syndrome, transforming the vast majority of acid refluxes into less toxic weakly acidic refluxes. However, typical GERD symptoms recur within 1 year in more than 90% of patients after PPI-withdrawal, in many of them within few days: thus, many patients become PPI-dependent and surgical therapy has been regarded as a treatment option for these patients [5].

Keywords

Laparoscopic Fundoplication Pneumatic Dilation Toupet Fundoplication Functional Heartburn Erosive Reflux Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Italia 2015

Authors and Affiliations

  • Gianluigi Melotti
  • Vincenzo Trapani
  • Marzio Frazzoni
  • Michele Varoli
  • Micaela Piccoli
    • 1
    Email author
  1. 1.General Surgery Unit“Sant’Agostino-Estense” New HospitalBaggiovara (MO)Italy

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