The use of medication after laparoscopic antireflux surgery

Abstract

LARS significantly reduced medication use at 1-year follow-up. However, these effects might be attributed, in part, to the multidisciplinary follow-up care. Further studies are therefore required to investigate which patients may benefit from multidisciplinary follow-up care and whether its selective application may reduce the need for medication after LARS.

Radiofrequency ablation if Barrett’s esophagus persists after fundoplication?

“…This is cardiac mucosa with goblet cells [4] and means an increased risk for the development of esophageal adenocarcinoma (0.5% annual risk). As shown by Ciovica et al [1], antireflux surgery worked by increasing the abdominal length of the lower esophageal sphincter by approximately 1 cm, which lead to normalization of esophageal acid exposure. Recent studies showed that effective fundoplication, i.e., pH monitoring proven control of reflux, will eliminate the risk for progression toward dysplasia and cancer [5].…”

“…In addition, the data by Ciovica et al [1] are of major oncological impact. Before the operation, 26.4% of patients had Barrett's esophagus.…”

“…With interest we read the article by Ciovica et al [1], entitled ''The use of medication after laparoscopic antireflux surgery,'' which has been published in the recent issue of Surgical Endoscopy. The paper comes from a group of surgeons with large experience in antireflux surgery.…”

“…In addition to their excellent surgical performance, the group elaborated an interdisciplinary approach toward gastroesophageal reflux disease (GERD) with meticulous patient workup, including high-quality endoscopy, esophageal function test, reflux monitoring, psychological support of patients, quality of life assessment [2] and life style education of patients [1]. One year after fundoplication, typical and atypical symptoms were absent in 95-100% of patients, 98% were off proton pump inhibitor (PPI) therapy, manometric characteristics of the lower esophageal sphincter and esophageal acid exposure normalized, and life quality significantly improved [1,2]. Thus, the ''Krems-antireflux program'' seems to be very successful and is in keeping with the results of previously published series [3].…”

The use of medication after laparoscopic anti-reflux surgery

“…We read with great interest the article entitled, ''The Use of Medication after Laparoscopic Antireflux Surgery'' [1]. We congratulate the authors for their results and great efforts; however, we have the following points that we think are complementary to the educational value of the study:…”