Brar Tony S, Draganov Peter V, Yang Dennis
Department of Medicine, University of Florida, Gainesville, FL, USA.
Division of Gastroenterology, Hepatology and Nutrition, University of Florida, 1329 SW 16th Street, Room #5251, Gainesville, FL, 32608, USA.
Dig Dis Sci. 2017 Jan;62(1):16-25. doi: 10.1007/s10620-016-4355-3. Epub 2016 Oct 28.
Gastroesophageal reflux disease (GERD) is a chronic disease characterized by symptoms of heartburn and acid regurgitation. Uncontrolled GERD can significantly impact quality of life, can lead to complications, and increases the risk of esophageal cancer. Over the past few decades, there has been an increasing prevalence of GERD among adults in Western populations. The use of proton pump inhibitors (PPI) in conjunction with lifestyle modifications remains the mainstay therapy. However, the efficacy of this intervention is often hampered by adherence, costs, and the risks of long-term PPI use. Anti-reflux surgery is an option for patients with refractory symptoms or in those in whom medical therapy is contraindicated or not desirable. While conventional surgery has an acceptable safety profile, there has been an increasing interest in alternate treatments that may potentially offer similar results and be associated with a faster recovery. Recent advances in interventional endoluminal techniques have introduced novel incisionless anti-reflux procedures. While the current data are promising, further larger prospective studies are needed in order to assess the long-term efficacy of endoluminal therapies and its place among the treatment options for GERD.
胃食管反流病（GERD）是一种以烧心和反酸症状为特征的慢性疾病。未得到控制的GERD会显著影响生活质量，可导致并发症，并增加食管癌风险。在过去几十年里，西方人群中成年人GERD的患病率一直在上升。质子泵抑制剂（PPI）与生活方式改变联合使用仍然是主要治疗方法。然而，这种干预措施的疗效常常受到依从性、成本以及长期使用PPI的风险的阻碍。抗反流手术是症状难治性患者或药物治疗禁忌或不理想患者的一种选择。虽然传统手术具有可接受的安全性，但人们对可能提供类似效果且恢复更快的替代治疗方法的兴趣日益增加。介入性腔内技术的最新进展引入了新型无切口抗反流手术。虽然目前的数据很有前景，但需要进一步开展更大规模的前瞻性研究，以评估腔内治疗的长期疗效及其在GERD治疗选择中的地位。
