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Antireflux surgery is equally beneficial in nonerosive and erosive gastroesophageal reflux disease

PURPOSE: Although nonerosive and erosive gastroesophageal reflux disease (GERD) have similar symptom severity, nonerosive reflux disease (NERD) is considered a milder type of GERD and gastroenterologists have hesitated to refer these patients for antireflux surgery. The aim of this study was to comp...

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Autores principales: Park, Joong-Min, Chi, Kyong-Choun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Surgical Society 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073042/
https://www.ncbi.nlm.nih.gov/pubmed/30079326
http://dx.doi.org/10.4174/astr.2018.95.2.94
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author Park, Joong-Min
Chi, Kyong-Choun
author_facet Park, Joong-Min
Chi, Kyong-Choun
author_sort Park, Joong-Min
collection PubMed
description PURPOSE: Although nonerosive and erosive gastroesophageal reflux disease (GERD) have similar symptom severity, nonerosive reflux disease (NERD) is considered a milder type of GERD and gastroenterologists have hesitated to refer these patients for antireflux surgery. The aim of this study was to compare surgical outcomes of antireflux surgery between patients with NERD and erosive reflux disease (ERD). METHODS: Seventy patients met the inclusion criteria of this study among a total of 117 patients who underwent antireflux surgery from November 2012 to October 2017. According to preoperative endoscopy, patients were classified into NERD group (minimal changes or no esophagitis) and ERD group. Clinical characteristics and surgical outcomes were compared between NERD and ERD. RESULTS: There were 26 patients in NERD group and 44 patients in ERD group. The male:female ratio was higher in the ERD group than in the NERD group (P = 0.044). Preoperative symptoms, response to acid suppressive medication, acid exposure on pH monitoring study, and esophageal manometry results were similar in the 2 groups. Reflux on barium esophagography was more frequently observed in ERD (77.3%) than in NERD (50.0%, P = 0.019). At 6 months after surgery, complete resolution and partial improvement of GERD symptoms were similar in the 2 groups (80.8% and 15.4%, respectively, in NERD vs. 88.6% and 2.3%, respectively, in ERD; P = 0.363). CONCLUSION: Laparoscopic Nissen fundoplication is equally beneficial to patients with NERD and ERD. Antireflux surgery should not be avoided for GERD patients without mucosal breaks on endoscopy as the evidence of erosive esophagitis.
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spelling pubmed-60730422018-08-03 Antireflux surgery is equally beneficial in nonerosive and erosive gastroesophageal reflux disease Park, Joong-Min Chi, Kyong-Choun Ann Surg Treat Res Original Article PURPOSE: Although nonerosive and erosive gastroesophageal reflux disease (GERD) have similar symptom severity, nonerosive reflux disease (NERD) is considered a milder type of GERD and gastroenterologists have hesitated to refer these patients for antireflux surgery. The aim of this study was to compare surgical outcomes of antireflux surgery between patients with NERD and erosive reflux disease (ERD). METHODS: Seventy patients met the inclusion criteria of this study among a total of 117 patients who underwent antireflux surgery from November 2012 to October 2017. According to preoperative endoscopy, patients were classified into NERD group (minimal changes or no esophagitis) and ERD group. Clinical characteristics and surgical outcomes were compared between NERD and ERD. RESULTS: There were 26 patients in NERD group and 44 patients in ERD group. The male:female ratio was higher in the ERD group than in the NERD group (P = 0.044). Preoperative symptoms, response to acid suppressive medication, acid exposure on pH monitoring study, and esophageal manometry results were similar in the 2 groups. Reflux on barium esophagography was more frequently observed in ERD (77.3%) than in NERD (50.0%, P = 0.019). At 6 months after surgery, complete resolution and partial improvement of GERD symptoms were similar in the 2 groups (80.8% and 15.4%, respectively, in NERD vs. 88.6% and 2.3%, respectively, in ERD; P = 0.363). CONCLUSION: Laparoscopic Nissen fundoplication is equally beneficial to patients with NERD and ERD. Antireflux surgery should not be avoided for GERD patients without mucosal breaks on endoscopy as the evidence of erosive esophagitis. The Korean Surgical Society 2018-08 2017-07-30 /pmc/articles/PMC6073042/ /pubmed/30079326 http://dx.doi.org/10.4174/astr.2018.95.2.94 Text en Copyright © 2018, the Korean Surgical Society http://creativecommons.org/licenses/by-nc/4.0/ Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Park, Joong-Min
Chi, Kyong-Choun
Antireflux surgery is equally beneficial in nonerosive and erosive gastroesophageal reflux disease
title Antireflux surgery is equally beneficial in nonerosive and erosive gastroesophageal reflux disease
title_full Antireflux surgery is equally beneficial in nonerosive and erosive gastroesophageal reflux disease
title_fullStr Antireflux surgery is equally beneficial in nonerosive and erosive gastroesophageal reflux disease
title_full_unstemmed Antireflux surgery is equally beneficial in nonerosive and erosive gastroesophageal reflux disease
title_short Antireflux surgery is equally beneficial in nonerosive and erosive gastroesophageal reflux disease
title_sort antireflux surgery is equally beneficial in nonerosive and erosive gastroesophageal reflux disease
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6073042/
https://www.ncbi.nlm.nih.gov/pubmed/30079326
http://dx.doi.org/10.4174/astr.2018.95.2.94
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