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Surgical treatment of gastroesophageal reflux disease

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Abstract

Background

Gastroesophageal reflux disease is by far the most prevalent disorder of the foregut. For a long time during the twentieth century, surgical therapy was the mainstay of treatment and the only chance for cure for patients with severe symptoms. Later, after introduction of proton pump inhibitor therapy in the early 1990s, surgical therapy was considered widely a second choice option due to its potential morbidity and side effects. More recently, however, there is growing evidence that long-term antisecretory therapy might be associated to a number of adverse effects such as osteoporosis and increased risk of cardiovascular events. This is the rationale why interventional and surgical options are coming back into focus.

Purpose

The purpose of this review is to analyze and to discuss the current spectrum of surgical therapy of gastroesophageal reflux disease.

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References

  1. Dent J, El-Serag HB, Wallander MA et al (2005) Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 54:710–717

    Article  PubMed  CAS  Google Scholar 

  2. Bollschweiler E, Knoppe K, Wolfgarten E, Hoelscher AH (2008) Prevalence of dysphagia in patients with gastroesophageal reflux in Germany. Dysphagia 23(2):172–6

    Article  PubMed  Google Scholar 

  3. van Pinxteren B, Sigterman KE, Bonis P, Lau J, Numans ME (2010) Short-term treatment with proton pump inhibitors, H2-receptor antagonists and prokinetics for gastro-oesophageal reflux disease-like symptoms and endoscopy negative reflux disease. Cochrane Database Syst Rev Nov 10;(11):CD002095

    Google Scholar 

  4. Spechler SJ, Lee E, Ahnen D et al (2001) Long-term outcome of medical and surgical therapies for gastroesophageal reflux disease: follow up of a randomised controlled trial. JAMA 285:2331–8

    Article  PubMed  CAS  Google Scholar 

  5. Grant AM, Wileman SM, Ramsay CR et al (2008) Minimal access surgery compared with medical management for chronic gastro-oesophageal reflux disease: UK collaborative randomised trial. BMJ 337:a2664

    Article  PubMed  Google Scholar 

  6. Galmiche JP, Hatlebakk J, Attwood S, Ell C, Fiocca R, Eklund S, Långström G, Lind T, Lundell L (2011) LOTUS Trial Collaborators. Laparoscopic antireflux surgery vs esomeprazole treatment for chronic GERD: the LOTUS randomized clinical trial. JAMA 305(19):1969–77

    Article  PubMed  CAS  Google Scholar 

  7. AGA (2008) GERD Patient Survey. available at www.gastro.org

  8. Kahrilas PJ, Jonsson A, Denison H, Wernersson B, Hughes N, Howden CW (2012) Regurgitation is less responsive to acid suppression than heartburn in patients with gastroesophageal reflux disease. Clin Gastroenterol Hepatol. Feb 14 (in press)

  9. von Rahden BH, Scheurlen M, Filser J, Stein HJ, Germer CT (2012) Newly recognized side-effects of proton pump inhibitors. Arguments in favour of fundoplication for GERD? Chirurg 83(1):38–44

    Article  Google Scholar 

  10. Nissen R (1956) Eine einfache Operation zur Beeinflussung der Refluxösophagitis. Schweiz Med Wochenschr 86(Suppl 20):590–2

    PubMed  CAS  Google Scholar 

  11. Dallemagne B, Weerts JM, Jehaes C, Markiewicz S, Lombard R (1991) Laparoscopic Nissen fundoplication: preliminary report. Surg Laparosc Endosc 1(3):138–43

    PubMed  CAS  Google Scholar 

  12. Wileman SM, McCann S, Grant AM, Krukowski ZH, Bruce J (2010) Medical versus surgical management for gastro-oesophageal reflux disease (GORD) in adults. Cochrane Database Syst Rev 17(3):CD003243

    Google Scholar 

  13. Lundell L (2010) Surgical therapy of gastro-oesophageal reflux disease. Best Pract Res Clin Gastroenterol 24(6):947–59

    Article  PubMed  Google Scholar 

  14. Spechler SJ, Lee E, Ahnen D, Goyal RK, Hirano I, Ramirez F, Raufman JP, Sampliner R, Schnell T, Sontag S, Vlahcevic ZR, Young R, Williford W (2001) Long-term outcome of medical and surgical therapies for gastroesophageal reflux disease: follow-up of a randomized controlled trial. JAMA 285(18):2331–8

    Article  PubMed  CAS  Google Scholar 

  15. Samelson SL, Weiser HF, Bombeck CT, Siewert JR, Ludtke FE, Hoelscher AH, Abuabara SF, Nyhus LM (1983) A new concept in the surgical treatment of gastroesophageal reflux. Ann Surg 197(3):254–9

    Article  PubMed  CAS  Google Scholar 

  16. Mittal RK, Holloway RH, Penagini R, Blackshaw LA, Dent J (1995) Transient lower esophageal sphincter relaxation. Gastroenterology 109(2):601–10

    Article  PubMed  CAS  Google Scholar 

  17. Ayazi S, Tamhankar A, DeMeester SR, Zehetner J, Wu C, Lipham JC, Hagen JA, DeMeester TR (2010) The impact of gastric distension on the lower esophageal sphincter and its exposure to acid gastric juice. Ann Surg 252(1):57–62

    Article  PubMed  Google Scholar 

  18. Gutschow CA, Schröder W, Bludau M, Vallböhmer D, Prenzel KL, Bollschweiler E, Hölscher AH (2011) Value of distal gastrectomy as a remedial operation for failed fundoplication. Zentralbl Chir 136(3):249–55

    Article  PubMed  CAS  Google Scholar 

  19. Holt CJ, Large AM (1961) Surgical management of reflux esophagitis. Ann Surg 153(4):555–62

    Article  PubMed  CAS  Google Scholar 

  20. Ellis FH, Gibb SP (1994) Vagotomy, antrectomy, and Roux-en-Y diversion for complex reoperative gastroesophageal reflux disease. Ann Surg 220:536–543

    Article  PubMed  Google Scholar 

  21. Csendes A, Burdiles P, Braghetto I, Korn O, Díaz JC, Rojas J (2002) Early and late results of the acid suppression and duodenal diversion operation in patients with Barrett's esophagus: analysis of 210 cases. World J Surg 26:566–76

    Article  PubMed  Google Scholar 

  22. Awais O, Luketich JD, Tam J, Irshad K, Schuchert MJ, Landreneau RJ, Pennathur A (2008) Roux-en-Y near esophagojejunostomy for intractable gastroesophageal reflux after antireflux surgery. Ann Thorac Surg 85:1954–61

    Article  PubMed  Google Scholar 

  23. Zainabadi K, Courcoulas AP, Awais O, Raftopoulos I (2008) Laparoscopic revision of Nissen fundoplication to Roux-en-Y gastric bypass in morbidly obese patients. Surg Endosc 22:2737–2740

    Article  PubMed  Google Scholar 

  24. Bais JE, Bartelsman JF, Bonjer HJ, Cuesta MA, Go PM, Klinkenberg-Knol EC, van Lanschot JJ, Nadorp JH, Smout AJ, van der Graaf Y, Gooszen HG (2000) Laparoscopic or conventional Nissen fundoplication for gastro-oesophageal reflux disease: randomised clinical trial. The Netherlands Antireflux Surgery Study Group. Lancet 355(9199):170–4

    Article  PubMed  CAS  Google Scholar 

  25. Peters MJ, Mukhtar A, Yunus RM, Khan S, Pappalardo J, Memon B, Memon MA (2009) Meta-analysis of randomized clinical trials comparing open and laparoscopic anti-reflux surgery. Am J Gastroenterol 104(6):1548–61

    Article  PubMed  Google Scholar 

  26. Draaisma WA, Buskens E, Bais JE, Simmermacher RK, Rijnhart-de Jong HG, Broeders IA, Gooszen HG (2006) Randomized clinical trial and follow-up study of cost-effectiveness of laparoscopic versus conventional Nissen fundoplication. Br J Surg 93(6):690–7

    Article  PubMed  CAS  Google Scholar 

  27. Yang H, Meun C, Sun X, Watson DI (2012) Outcome following management of dysphagia after laparoscopic anti-reflux surgery. World J Surg. Feb 1. (in press)

  28. Toupet A (1963) Technique d’oesophago-gastroplastie avec phrenogastropexie appliquée dans la cure radicale des hernies hiatales et comme complément de l’opération de Heller dans les cardiospasmes. Mem Acad Chir 11:394–8

    Google Scholar 

  29. Dor J, Humbet P, Dor V et al (1962) L’intéret de la technique de Nissen modifée dans la prévention du reflux après cardiomyotomie extra-muqueuse de Heller. M Acad Chir 88:877–84

    Google Scholar 

  30. Belsey R (1995) The mark IV antireflux procedure. Ann Chir Gynaecol 84:107–13

    PubMed  CAS  Google Scholar 

  31. Watson A, Spychal RT, Brown MG, Peck N, Callander N (1995) Laparoscopic 'physiological' antireflux procedure: preliminary results of a prospective symptomatic and objective study. Br J Surg 82(5):651–6

    Article  PubMed  CAS  Google Scholar 

  32. Hill LD (1967) An effective operation for hiatal hernia: an eight-year appraisal. Ann Surg 166:681

    Article  PubMed  CAS  Google Scholar 

  33. Lind J, Burns CM, MacDougal JT (1965) A physiological repair for hiatus hernia: manometric study. Arch Surg 91:233

    Article  Google Scholar 

  34. Mardani J, Lundell L, Engström C (2011) Total or posterior partial fundoplication in the treatment of GERD: results of a randomized trial after 2 decades of follow-up. Ann Surg 253(5):875–8

    Article  PubMed  Google Scholar 

  35. Ramos RF, Lustosa SA, de Almeida CA, da Silva CP, Matos D (2011) Surgical treatment of gastroesophageal reflux disease: total or partial fundoplication? systematic review and meta-analysis. Arq Gastroenterol 48(4):252–60

    PubMed  Google Scholar 

  36. Broeders JA, Mauritz FA, Ahmed Ali U, Draaisma WA, Ruurda JP, Gooszen HG, Smout AJ, Broeders IA, Hazebroek EJ (2010) Systematic review and meta-analysis of laparoscopic Nissen (posterior total) versus Toupet (posterior partial) fundoplication for gastro-oesophageal reflux disease. Br J Surg 97(9):1318–30

    Article  PubMed  CAS  Google Scholar 

  37. Tan G, Yang Z, Wang Z (2011) Meta-analysis of laparoscopic total (Nissen) versus posterior (Toupet) fundoplication for gastro-oesophageal reflux disease based on randomized clinical trials. ANZ J Surg 81(4):246–52

    Article  PubMed  Google Scholar 

  38. Varin O, Velstra B, De Sutter S, Ceelen W (2009) Total vs partial fundoplication in the treatment of gastroesophageal reflux disease: a meta-analysis. Arch Surg 144(3):273–8

    Article  PubMed  Google Scholar 

  39. Broeders JA, Roks DJ, Ahmed Ali U, Draaisma WA, Smout AJ, Hazebroek EJ (2011) Laparoscopic anterior versus posterior fundoplication for gastroesophageal reflux disease: systematic review and meta-analysis of randomized clinical trials. Ann Surg 254(1):39–47

    Article  PubMed  Google Scholar 

  40. Rossetti ME (1996) Nissen fundoplication for gastroesophageal reflux disease: the ‘Rossetti’ modification of the Nissen fundoplication—technique and results. Dis Esophagus 9:251–7

    Google Scholar 

  41. DeMeester TR, Bonavina L, Albertucci M (1986) Nissen fundoplication for gastroesophageal reflux disease. Evaluation of primary repair in 100 consecutive patients. Ann Surg 204(1):9–20

    Article  PubMed  CAS  Google Scholar 

  42. Chrysos E, Tzortzinis A, Tsiaoussis J, Athanasakis H, Vassiliakis J, Xynos E (2001) Prospective randomized trial comparing Nissen to Nissen–Rossetti technique for laparoscopic fundoplication. Am J Surg 182:215–221

    Article  PubMed  CAS  Google Scholar 

  43. Farah JF, Grande JC, Goldenberg A, Martinez JC, Lupinacci RA, Matone J (2007) Randomized trial of total fundoplication and fundal mobilization with or without division of short gastric vessels: a short-term clinical evaluation. Acta Cir Bras 22:422–429

    Article  PubMed  Google Scholar 

  44. Blomqvist A, Dalenbäck J, Hagedorn C, Lönroth H, Hyltander A, Lundell L (2000) Impact of complete gastric fundus mobilization on outcome after laparoscopic total fundoplication. J Gastrointest Surg 4:493–500

    Article  PubMed  CAS  Google Scholar 

  45. Watson DI, Pike GK, Baigrie RJ, Mathew G, Devitt PG, Britten-Jones R et al (1997) Prospective double-blind randomized trial of laparoscopic Nissen fundoplication with division and without division of short gastric vessels. Ann Surg 226:642–652

    Article  PubMed  CAS  Google Scholar 

  46. Luostarinen ME, Koskinen MO, Isolauri JO (1996) Effect of fundal mobilisation in Nissen–Rossetti fundoplication on oesophageal transit and dysphagia. A prospective, randomised trial. Eur J Surg 162:37–42

    PubMed  CAS  Google Scholar 

  47. Engström C, Jamieson GG, Devitt PG, Watson DI (2011) Meta-analysis of two randomized controlled trials to identify long-term symptoms after division of the short gastric vessels during Nissen fundoplication. Br J Surg 98(8):1063–7

    Article  PubMed  Google Scholar 

  48. Hashemi M, Peters JH, DeMeester TR, Huprich JE, Quek M, Hagen JA, Crookes PF, Theisen J, DeMeester SR, Sillin LF, Bremner CG (2000) Laparoscopic repair of large type III hiatal hernia: objective follow-up reveals high recurrence rate. J Am Coll Surg 190(5):553–60

    Article  PubMed  CAS  Google Scholar 

  49. Siewert JR (2008) Historic perspective and the work of Pointner and Granderath in hiatus hernia and recurrence. Chirurg 79(10):982–3

    Article  PubMed  CAS  Google Scholar 

  50. Chew CR, Jamieson GG, Devitt PG, Watson DI (2011) Prospective randomized trial of laparoscopic Nissen fundoplication with anterior versus posterior hiatal repair: late outcomes. World J Surg 35(9):2038–44

    Article  PubMed  Google Scholar 

  51. Herbella FAM, Patti MG, Del Grande JC (2011) Hiatal mesh repair—current status. Surg Laparosc Endosc Percutan Tech 21:61–66

    Article  PubMed  Google Scholar 

  52. Pointner R, Granderath FA (2008) Hiatushernie und Rezidive. Die Achillessehne der Antirefluxchirurgie? Chirurg 79:974–981

    Article  PubMed  CAS  Google Scholar 

  53. Stadlhuber RJ, Sherif AE, Mittal SK, Fitzgibbons RJ Jr, Michael Brunt L, Hunter JG, Demeester TR, Swanstrom LL, Daniel Smith C, Filipi CJ (2009) Mesh complications after prosthetic reinforcement of hiatal closure: a 28-case series. Surg Endosc 23(6):1219–26

    Article  PubMed  Google Scholar 

  54. Volonté F, Collard JM, Goncette L, Gutschow C, Strignano P (2007) Intrathoracic periesophageal fundoplication for short esophagus: a 20-year experience. Ann Thorac Surg 83(1):265–71

    Article  PubMed  Google Scholar 

  55. Mattioli S, D’Ovidio F, Di Simone MP, Bassi F, Brusori S, Pilotti V, Felice V, Ferruzzi L, Guernelli N (1998) Clinical and surgical relevance of the progressive phases of intrathoracic migration of the gastroesophageal junction in gastroesophageal reflux disease. J Thorac Cardiovasc Surg 116:267–275

    Article  PubMed  CAS  Google Scholar 

  56. Belsey RHR (1980) Gastroesophageal reflux. Am J Surg 139:775–781

    Article  PubMed  CAS  Google Scholar 

  57. Nissen R, Rossetti M (1959) Die Behandlung von Hiatushernien und Refluxösophagitis mit Gastropexie und Fundoplicatio. Indikation, Technik und Ergebnisse. Georg Thieme Verlag, Stuttgart, p 138

    Google Scholar 

  58. Effler D, Ballinger C (1951) Complications and surgical treatment of hiatus hernia and short esophagus. J Thorac Surg 21:235–247

    Google Scholar 

  59. Orringer MB, Sloan H (1976) Collis-Belsey reconstruction of the esophagogastric junction: indications, physiology and technical considerations. J Thorac Cardiovasc Surg 71:295–303

    PubMed  CAS  Google Scholar 

  60. Orringer MB, Orringer JS (1982) The combined Collis-Nissen operation: early assessment of reflux control. Ann Thorac Surg 33:534–539

    Article  PubMed  CAS  Google Scholar 

  61. Maillet P, Beaulieux J, Dumurgier C (1976) A propos du traitement des brachyoesophages acquis. Chirurgie 102:519–524

    PubMed  CAS  Google Scholar 

  62. Herrington J, Mody B (1976) Total duodenal diversion for treatment of reflux esophagitis uncontrolled by repeated antireflux procedures. Ann Surg 183:636–644

    Article  PubMed  Google Scholar 

  63. Symons NR, Purkayastha S, Dillemans B, Athanasiou T, Hanna GB, Darzi A, Zacharakis E (2011) Laparoscopic revision of failed antireflux surgery: a systematic review. Am J Surg 202(3):336–43

    Article  PubMed  Google Scholar 

  64. Angelchik JP, Cohen R (1979) A new surgical procedure for the treatment of gastroesophageal reflux and hiatal hernia. Surg Gynecol Obstet 148(2):246–8

    PubMed  CAS  Google Scholar 

  65. Berguer R, Stiegmann GV, Yamamoto M, Kim J, Mansour A, Denton J, Norton LW, Angelchik JP (1991) Minimal access surgery for gastroesophageal reflux: laparoscopic placement of the Angelchik prosthesis in pigs. Surg Endosc 5(3):123–6

    Article  PubMed  CAS  Google Scholar 

  66. Hill AD, Walsh TN, Bolger CM, Byrne PJ, Hennessy TP (1994) Randomized controlled trial comparing Nissen fundoplication and the Angelchik prosthesis. Br J Surg 81(1):72–4

    Article  PubMed  CAS  Google Scholar 

  67. Kmiot WA, Kirby RM, Akinola D, Temple JG (1991) Prospective randomized trial of Nissen fundoplication and Angelchik prosthesis in the surgical treatment of medically refractory gastro-oesophageal reflux disease. Br J Surg 78(10):1181–4

    Article  PubMed  CAS  Google Scholar 

  68. Eyre-Brook IA, Codling BW, Gear MW (1993) Results of a prospective randomized trial of the Angelchik prosthesis and of a consecutive series of 119 patients. Br J Surg 80(5):602–4

    Article  PubMed  CAS  Google Scholar 

  69. Thibault C, Marceau P, Biron S, Bourque RA, Béland L, Potvin M (1994) The Angelchik antireflux prosthesis: long-term clinical and technical follow-up. Can J Surg 37(1):12–7

    PubMed  CAS  Google Scholar 

  70. Bonavina L, DeMeester T, Fockens P, Dunn D, Saino G, Bona D, Lipham J, Bemelman W, Ganz RA (2010) Laparoscopic sphincter augmentation device eliminates reflux symptoms and normalizes esophageal acid exposure: one- and 2-year results of a feasibility trial. Ann Surg 252(5):857–62

    Article  PubMed  Google Scholar 

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  1. Department of General, Visceral, and Cancer Surgery, University of Cologne, Kerpener Strasse 62, 50931, Cologne, Germany

    Christian A. Gutschow & Arnulf H. Hölscher

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  1. Christian A. Gutschow
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Correspondence to Christian A. Gutschow.

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Gutschow, C.A., Hölscher, A.H. Surgical treatment of gastroesophageal reflux disease. Langenbecks Arch Surg 398, 661–667 (2013). https://doi.org/10.1007/s00423-012-0952-6

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