Department of Thoracic Medicine and Surgery, Temple University Hospital, Lewis Katz School of Medicine, 3401 North Broad Street, C501, 5th Floor, Parkinson Pavilion, Philadelphia, PA 19140, USA; Department of Surgery, Einstein Medical Center, Klein 101, Philadelphia, PA 19141, USA.
Department of Thoracic Medicine and Surgery, Temple University Hospital, Lewis Katz School of Medicine, 3401 North Broad Street, C501, 5th Floor, Parkinson Pavilion, Philadelphia, PA 19140, USA.
Gastroenterol Clin North Am. 2020 Sep;49(3):467-480. doi: 10.1016/j.gtc.2020.04.005. Epub 2020 Jun 16.
The incidence of gastroesophageal reflux disease (GERD) remains on the rise. Pathophysiology of GERD is multifactorial, revolving around an incompetent esophagogastric junction as an antireflux barrier, with other comorbid conditions contributing to the disease. Proton pump inhibitors remain the most common treatment of GERD. Endoscopic therapy has gained popularity as a less invasive option. The presence of esophageal dysmotility complicates the choice of surgical fundoplication. Most literature demonstrates that fundoplication is safe in the setting of ineffective or weak peristalsis and that postoperative dysphagia cannot be predicted by preoperative manometry parameters. More data are needed on the merits of endoluminal approaches to GERD.
胃食管反流病（GERD）的发病率仍在上升。GERD 的病理生理学是多因素的，围绕着一个功能失调的食管胃交界处作为抗反流屏障，其他合并症也导致了这种疾病。质子泵抑制剂仍然是 GERD 的最常见治疗方法。内镜治疗作为一种较少侵入性的选择越来越受欢迎。食管动力障碍的存在使手术胃底折叠术的选择变得复杂。大多数文献表明，在蠕动无效或减弱的情况下，胃底折叠术是安全的，并且术前测压参数无法预测术后吞咽困难。需要更多关于 GERD 经内腔途径的优点的数据。
