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Are laparoscopic antireflux procedures useful?

Nature Clinical Practice Gastroenterology & Hepatology volume 2, pages 2–3 (2005)Cite this article

Laparoscopic antireflux surgery (LARS) is currently considered the gold standard for surgical treatment of gastroesophageal reflux disease (GERD). During the last decade, the tremendous increase in the number of operations performed has resulted in an increased understanding of the physiology of the gastric cardia, and has therefore led to improved operative techniques. In contrast to medical therapy, which neutralizes the gastric refluxate, LARS, by controlling reflux, provides excellent relief of typical GERD symptoms and many chronic respiratory diseases. In certain cases LARS can also reverse reflux-related injury (e.g. in BARRETT'S ESOPHAGUS). As a result, LARS should be considered an excellent alternative to medical therapy for GERD-related problems. Let us review the evidence.

LARS has been shown to be very effective at alleviating symptoms in 88–95% of patients with GERD, with excellent patient satisfaction in short-term as well as in long-term follow-up studies.1,2 These excellent results include patients with complicated GERD, such as those with large HIATAL HERNIAS, refractory ESOPHAGITIS and peptic strictures. Such patients have no other alternative because medical therapy usually proves inadequate in these circumstances. The effectiveness of LARS has been objectively confirmed with 24-h pH MONITORING, which has clearly shown excellent control of esophageal acid exposure more than 5 years after the operation.2

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  1. Surgical Chief Resident and BK Oelschlager is Assistant Professor, at the Department of Surgery, University of Washington, WA, USA

    Kurt E Roberts & Brant K Oelschlager

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  1. Kurt E Roberts
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  2. Brant K Oelschlager
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Correspondence to Brant K Oelschlager.

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Roberts, K., Oelschlager, B. Are laparoscopic antireflux procedures useful?. Nat Rev Gastroenterol Hepatol 2, 2–3 (2005). https://doi.org/10.1038/ncpgasthep0065

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