Current interventional management of gastroesophageal reflux disease

Luigi Bonavina


Gastroesophageal reflux disease (GERD) is a chronic condition with a tremendous negative impact on both health-related quality of life and healthcare resource utilization. It is also a progressive disease that may lead to Barrett’s esophagus and adenocarcinoma. In addition, more than one third of GERD patients are partially responders/ non-responders to proton-pump inhibitors and there is growing concern regarding the safety of long-term pharmacological therapy. Interventional therapy in these patients can be performed either through laparoscopy or flexible endoscopy. Both methods have the potential to reinforce the lower esophageal sphincter and to protect the esophageal mucosa from retrograde flow of both acid and alkaline gastric contents. However, a concomitant hiatal repair is feasible only through a laparoscopic approach.

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