Choice of operating procedure in the surgical treatment of gastroesophageal reflu x disease (GERD)

Abstract

Today a conservative tactic of treatment of gastroesophageal reflux disease is generally accepted. Surgical treatment is justified with the resistance of the symptoms of the disease to drug therapy. That variant of GERD is notes in 10–15% of patients. One of the key problems of antireflux surgery is the selection of the optimal technique of the gastroesophageal junctionreconstruction. Executing the most effective options for surgical interventions often leads to the occurrence of clinically significant side effects. On the contrary, the implementation of light reconstructions does not always allow for sufficient control of the disease symptoms. In the article, from the positions of anatomy and physiology of the upper digestive tract, and detailed analysis of the mechanisms of action of various antireflux procedures, the principles of choosing the procedure for surgical treatment of gastroesophageal reflux disease are presented.