Seo Ho Seok, Choi Miyoung, Son Sang-Yong, Kim Min Gyu, Han Dong-Seok, Lee Han Hong
Guideline Committee of Korean Anti-Reflux Surgery (KARS) Study Group.
Division of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Gastric Cancer. 2018 Dec;18(4):313-327. doi: 10.5230/jgc.2018.18.e41. Epub 2018 Dec 27.
The prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea, and physicians, including surgeons, have been focusing on its treatment. Indeed, in Korea, medical treatment using a proton pump inhibitor is the mainstream treatment for GERD, while awareness of surgical treatment is limited. Accordingly, to promote the understanding of surgical treatment for GERD, the Korean Anti-Reflux Surgery Study Group published the Evidence-Based Practice Guideline for the Surgical Treatment of GERD. The guideline consists of 2 sections: fundamental information such as the definition, symptoms, and diagnostic tools of GERD and a recommendation statement about its surgical treatment. The recommendations presented 5 debates regarding fundoplication: 1) comparison of the effectiveness of medical and surgical treatments, 2) effectiveness of surgical treatment in cases of refractory GERD, 3) effectiveness of surgical treatment of extraesophageal symptoms, 4) comparison of effectiveness between total and partial fundoplication, and 5) effectiveness of fundoplication in cases of hiatal hernia. The present guideline is the first to demonstrate the efficacy of the surgical treatment GERD in Korea.
在韩国，胃食管反流病（GERD）的患病率正在上升，包括外科医生在内的医生们一直专注于其治疗。事实上，在韩国，使用质子泵抑制剂进行药物治疗是GERD的主流治疗方法，而对手术治疗的认知有限。因此，为了增进对GERD手术治疗的理解，韩国抗反流手术研究小组发布了《GERD手术治疗的循证实践指南》。该指南由两部分组成：GERD的定义、症状和诊断工具等基本信息，以及关于其手术治疗的推荐声明。这些推荐提出了关于胃底折叠术的5个争议点：1）药物治疗与手术治疗效果的比较；2）难治性GERD病例中手术治疗的效果；3）食管外症状手术治疗的效果；4）全胃底折叠术与部分胃底折叠术效果的比较；5）食管裂孔疝病例中胃底折叠术的效果。本指南首次证明了韩国GERD手术治疗的疗效。
