Department of Surgery, University of Athens School of Medicine, Attikon University Hospital, Rimini 1, Chaidari, Athens 12462, Greece.
Gastroenterol Res Pract. 2009;2009:371580. doi: 10.1155/2009/371580. Epub 2009 Dec 31.
Gastroesophageal reflux disease is a common condition with increasing prevalence worldwide. The disease encompasses a broad spectrum of clinical symptoms and disorders from simple heartburn without esophagitis to erosive esophagitis with severe complications, such as esophageal strictures and intestinal metaplasia. Diagnosis is based mainly on ambulatory esophageal pH testing and endoscopy. There has been a long-standing debate about the best treatment approach for this troublesome disease.
Medical treatment with PPIs has an excellent efficacy in reversing the symptoms of GERD, but they should be taken for life, and long-term side effects do exist. However, patients who desire a permanent cure and have severe complications or cannot tolerate long-term treatment with PPIs are candidates for surgical treatment. Laparoscopic antireflux surgery achieves a significant symptom control, increased patient satisfaction, and complete withdrawal of antireflux medications, in the majority of patients.
Surgical treatment should be reserved mainly for young patients seeking permanent results. However, the choice of the treatment schedule should be individualized for every patient. It is up to the patient, the physician and the surgeon to decide the best treatment option for individual cases.
胃食管反流病是一种常见疾病，全球患病率呈上升趋势。该疾病涵盖了广泛的临床症状和疾病谱，从单纯的烧心而无食管炎到伴有严重并发症的糜烂性食管炎，如食管狭窄和肠化生。诊断主要基于动态食管 pH 检测和内镜检查。对于这种棘手的疾病，哪种治疗方法最佳一直存在争议。
质子泵抑制剂 (PPI) 的药物治疗在逆转 GERD 症状方面具有极好的疗效，但需要终身服用，且长期存在副作用。然而，对于那些渴望根治、有严重并发症或不能耐受长期 PPI 治疗的患者，手术治疗是一种选择。腹腔镜抗反流手术可显著控制症状，提高患者满意度，并使大多数患者完全停用抗反流药物。
手术治疗主要应保留给寻求根治结果的年轻患者。然而，每位患者的治疗方案选择应个体化。对于具体病例，应由患者、医生和外科医生共同决定最佳治疗方案。
