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Surgical management of complicated gastroesophageal reflux disease

Chirurgische Therapie der komplizierten Refluxkrankheit

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Summary

Background: Gastroesophageal reflux disease (GERD) is a common condition and complications occur in up to 50 % of all patients. The treatment of these patients is challenging and requires surgical skill as well as theoretical background of GERD and its complications.

Methods: A survey is given of the management of complicated GERD including peptic strictures, Barrett’s esophagus, management of impaired esophageal body motility and treatment of patients following failed antireflux surgery.

Results: After identifying one of the named complications or the cause of failure of previous antireflux procedures, tailored surgery offers safe treatment of complicated GERD with reliable results.

Conclusions: Since medical treatment is likely to fail in patients with increasing severity of GERD including all complications the need for surgery arises and may be the only successful treatment.

Zusammenfassung

Grundlagen: Die gastroösophageale Refluxkrankheit (GERD) ist eine häufige Erkrankung mit einer Komplikationsrate von bis zu 50 %. Die Behandlung dieser Patienten stellt eine Herausforderung dar und erfordert sowohl chirurgische Erfahrung als auch theoretisches Wissen über die komplizierte Refluxkrankheit.

Methodik: Ein Überblick über die chirurgische Therapie der komplizierten Refluxkrankheit unter Berücksichtigung von peptischen Strikturen, Barretts Ösophagus, beeinträchtigter Ösophagusperistaltik und Behandlung von Patienten nach erfolgloser Antirefluxchirurgie wird präsentiert.

Ergebnisse: Die auf den jeweiligen Patienten zugeschnittene chirurgische Therapie bietet nach Idendifikation einer der erwähnten Komplikationen oder der Ursache der fehlgeschlagenen vorangegangenen Antirefluxchirurgie eine sichere und erfolgversprechende Behandlungsalternative.

Schlußfolgerungen: Mit zunehmendem Schwere- und Komplikationsgrad der Refluxerkrankung steigt die Wahrscheinlichkeit des Versagens der medikamentösen Behandlung. Die chirurgische Therapie bietet sich in zunehmendem Maß als Alternative dazu an und kann unter Umständen die einzige erfolgversprechende Therapievariante sein.

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Correspondence to M. Gadenstätter.

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Gadenstätter, M., Wetscher, G.J. Surgical management of complicated gastroesophageal reflux disease. Acta Chir. Austriaca 32, 11–14 (2000). https://doi.org/10.1007/BF02949206

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Key words

  • Gastroesophageal reflux disease
  • complications
  • surgery

Schlüsselwörter

  • Gastroösophageale Refluxkrankheit
  • Komplikationen
  • Chirurgie