Pre-operative clinical and instrumental factors as antireflux surgery outcome predictors  

作　　者：Salvatore Tolone Giorgia Gualtieri Edoardo Savarino Marzio Frazzoni Nicola de Bortoli Manuele Furnari Giuseppina Casalino Simona Parisi Vincenzo Savarino Ludovico Docimo 

机构地区：[1]Division of General and Bariatric Surgery, Second University of Naples [2]Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua [3]Division of Gastroenterology, Baggiovara Hospital [4]Division of Gastroenterology, Department of Internal Medicine, University of Pisa [5]Division of Gastro-enterology, Department of Internal Medicine, University of Genoa

出　　处：《World Journal of Gastrointestinal Surgery》2016年第11期719-728,共10页世界胃肠外科杂志（英文版）（电子版）

摘　　要：Gastroesophageal reflux disease(GERD) is nowadays a highly prevalent, chronic condition, with 10% to 30% of Western populations affected by weekly symptoms. Many patients with mild reflux symptoms are treated adequately with lifestyle modifications, dietary changes, and low-dose proton pump inhibitors(PPIs). For those with refractory GERD poorly controlled with daily PPIs, numerous treatment options exist. Fundoplication is currently the most commonly performed antireflux operation for management of GERD. Outcomes described in current literature following laparoscopic fundoplication indicate that it is highly effective for treatment of GERD; early clinical studies demonstrate relief of symptoms in approximately 85%-90% of patients. However it is still unclear which factors, clinical or instrumental, are able to predict a good outcome after surgery. Virtually all demographic, esophagogastric junction anatomic conditions, as well as instrumental(such as presence of esophagitis at endoscopy, or motility patterns determined by esophageal high resolution manometry or reflux patterns determined by means of pH /impedance-pH monitoring) and clinical features(such as typical or atypical symptoms presence) of patients undergoing laparoscopic fundoplication for GERD can be factors associated with symptomatic relief. With this in mind, we sought to review studies that identified the factors that predict outcome after laparoscopic total fundoplication.Gastroesophageal reflux disease (GERD) is nowadays a highly prevalent, chronic condition, with 10% to 30% of Western populations affected by weekly symptoms. Many patients with mild reflux symptoms are treated adequately with lifestyle modifications, dietary changes, and low-dose proton pump inhibitors (PPIs). For those with refractory GERD poorly controlled with daily PPIs, numerous treatment options exist. Fundoplication is currently the most commonly performed antireflux operation for management of GERD. Outcomes described in current literature following laparoscopic fundoplication indicate that it is highly effective for treatment of GERD; early clinical studies demonstrate relief of symptoms in approximately 85%-90% of patients. However it is still unclear which factors, clinical or instrumental, are able to predict a good outcome after surgery. Virtually all demographic, esophagogastric junction anatomic conditions, as well as instrumental (such as presence of esophagitis at endoscopy, or motility patterns determined by esophageal high resolution manometry or reflux patterns determined by means of pH/impedance-pH monitoring) and clinical features (such as typical or atypical symptoms presence) of patients undergoing laparoscopic fundoplication for GERD can be factors associated with symptomatic relief. With this in mind, we sought to review studies that identified the factors that predict outcome after laparoscopic total fundoplication.

关 键 词：GASTROESOPHAGEAL reflux disease ANTIREFLUX surgery Outcome predictors FUNDOPLICATION NISSEN Laparoscopy High resolution MANOMETRY ImpedancepH monitoring 

分 类 号：R571[医药卫生—消化系统]