Surgical treatment strategies for gastroesophageal reflux disease

Abstract

Gastroesophageal reflux disease (GERD) is a common digestive disorder with a global prevalence of approximately 13%. The primary surgical options include the 360° Nissen fundoplication, 270° Toupet fundoplication, and 180° Dor fundoplication. While the Nissen procedure demonstrates superior long-term outcomes compared to the other methods, it is associated with a higher incidence of postoperative dysphagia. Surgical decisions should be individualized based on esophageal motility and pH monitoring. The surgery not only aims to repair anatomical structures, but also to restore function, including the length of the abdominal esophagus and the angulation between the crura diaphragm and the spine. Reconstruction of the gastroesophageal valve and the phrenoesophageal fascia is crucial for optimizing surgical outcomes and preventing postoperative complications. Given the physiological and psychological changes associated with GERD, personalized treatment is essential for improving symptoms and enhancing quality of life.

Keywords

• |gastroesophageal reflux disease (gerd)|crura diaphragm (cd)|lower esophageal sphincter (les)|gastroesophageal valve|phrenoesophageal fascia