ASGE Esophagology: Tailoring Management from Testing to Treatment (On-Demand) | July 2022-Olaya Gutierrez

Olaya Gutierrez_Endsocopic-Surgical GERD

Pdf Summary

This document discusses minimally invasive endoscopic and surgical treatments for gastroesophageal reflux disease (GERD). It begins by acknowledging that while proton pump inhibitors (PPIs) are the first-line therapy for GERD, up to 40% of patients may have an incomplete or failed response to these medications. This has led to an increased interest in alternative therapies. The document explores various endoscopic treatment options for GERD, including radiofrequency therapy, transoral fundoplication, mucosal resection/ablation, and banding. It provides a summary of the data on the effectiveness and durability of these procedures, highlighting their impact on GERD symptoms, acid exposure, and the use of PPIs. <br /><br />The document also covers surgical anti-reflux therapies, such as laparoscopic fundoplication and magnetic sphincter augmentation (MSA). It compares different types of fundoplication procedures, discussing their durability, reflux control, dysphagia, and ability to belch or vomit. It further presents data on the outcomes and patient satisfaction with MSA compared to fundoplication. <br /><br />In conclusion, the document states that while PPIs remain the most cost-effective therapy for GERD symptom reduction, there is growing interest in alternative options. Endoscopic therapies are useful in patients with breakthrough symptoms on PPIs or those reluctant to take long-term medications. However, more research is needed to determine the best selection of therapy for individual patients. Ultimately, laparoscopic fundoplication continues to be the gold standard therapy for refractory GERD.

Keywords

minimally invasive

endoscopic treatments

surgical treatments

gastroesophageal reflux disease

proton pump inhibitors

alternative therapies

laparoscopic fundoplication

magnetic sphincter augmentation

reflux control

gold standard therapy