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Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition) ›› 2024, Vol. 18 ›› Issue (03): 241-246. doi: 10.3877/cma.j.issn.1674-392X.2024.03.001

• Expert Forum •    

Selection of indications and preoperative evaluation of anti-reflux surgery for extraesophageal symptoms of gastroesophageal reflux disease

Zhiwei Hu1, Jimin Wu1, Zhonghao Wang1, Meiguang Zhang1,()   

  1. 1. Gastroesophageal Surgery of PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
  • Received:2023-07-10 Online:2024-06-18 Published:2024-06-24
  • Contact: Meiguang Zhang

Abstract:

Gastroesophageal reflux disease (GERD) is a common and costly chronic disease, and usually causes extraesophageal symptoms. It is estimated that the global prevalence rate is 13.98%, and the number of patients worldwide is about 1.03 billion. The symptoms and reflux esophagitis caused by reflux can usually be effectively solved by internal acid suppression treatment. However, about one third of GERD patients receiving acid suppression treatment still have insufficient symptom control after 8 weeks of treatment. Moreover, acid suppression therapy is more difficult to effectively control the extraesophageal symptoms. In addition, people are increasingly concerned about the long-term consequences of the indefinite use of acid inhibitors. Anti-reflux surgery can mechanically repair and strengthen the anti-reflux barrier to prevent abnormal reflux of gastric contents into the esophagus and airway, thus providing a more effective alternative method to drug treatment that can maximize the control of GERD symptoms and avoid long-term medication. Through the analysis of the selection methods of patients in the previous studies of anti-reflux surgery for GERD extraesophageal symptoms, this paper provides a basis for guiding the clinical to conduct a detailed preoperative evaluation of GERD extraesophageal symptoms, optimizing the selection of surgical patients, and achieving the best surgical effect.

Key words: Gastroesophageal reflux disease, Extraesophageal symptoms, Reflux esophagitis, Hiatal hernia, Reflux monitoring, Fundoplication

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