GASTROESOPHAGEAL REFLUX THERAPY - WHAT IS THE ROLE OF SURGERY

There are several therapeutic options available to control the symptom s associated with gastroesophageal reflux disease (GERD). The majority of patients are adequately maintained by conservative measures or med ical therapy. Surgery traditionally has been reserved for patients res istant to maximum medical therapy or patients with recurrent aspiratio ns. Many patients who require long term medication would also respond well to antireflux surgery, but the postoperative pain, morbidity and mortality associated with open surgery has tended to sway most in favo ur of the medical option. However, recent adoption of laparoscopic tec hniques in performance of antireflux surgery may change this preferenc e. Early reports from the few centres engaged in assessment of laparos copic fundoplication suggest that this new procedure is associated wit h significantly shorter hospital stay, quicker recovery, and reduced m orbidity and mortality compared with convention open fundoplication. T his has led to a surge of enthusiasm among patients and physicians who see this procedure as a serious alternative to long term medical ther apy. There is no doubt that if the long term results of laporoscopic f undoplication proves to be similar to open surgery, it will become an important option in treatment of patients with GERD.