Antireflux surgery

Esophageal manometry to evaluate motility should be performed in any patient who is a candidate for antireflux surgery. It is useful in determining which surgical procedure is best for the patient. 

Phase III Interventional therapies (antireflux surgery or endoluminal therapies). 

Ranitidine 150 mg four times daily Antireflux surgery or endoscopic therapies... 

Treatment of GERD involves a stepwise approach determined by disease severity and includes lifestyle changes and patient-directed therapy (phase I) pharmacologic treatment with nonprescription and prescription medications (phase II) and interventional approaches such as antireflux surgery or endoluminal therapies (phase III). 

Interventional approaches (antireflux surgery or endoluminal therapies) offer an alternative treatment for refractory GERD or when pharmacologic management is undesirable. 

A summation of published data on the results of laparoscopic antireflux surgery (1/1/2003, I.M. Modlin). 

An issue not addressed by this study, however, is the question of the longevity of the surgery. In fact, there is a paucity of studies on the long-term durability of laparoscopic antireflux surgery, and only a few have examined patient status at 5... 

A further issue that has been used to support the position of surgery has been the notional consideration that antireflux surgery should decrease health care use. A retrospective matched cohort study of Tennessee Medicaid patients compared the costs of medical and surgical treatment for GERD in 1996. The study compared 135 patients who had fundoplication with 250 randomly selected patients from a group of more than 7,000 who were treated medically. 

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