Surgical Treatment Of Gastroesophageal Reflux

Gastroesophageal reflux is defined as a decline in the barrier function that prevents reflux from causing the contents of the stomach to flow back into the esophagus.
Gastroesophageal reflux is a mechanical abnormality caused by weakening of the lower esophageal sphincter, gastric emptying function or loss of esophageal motility.
These abnormalities cause a group of conditions ranging from mild heartburn to severe esophageal tissue damage along with associated complications.
Symptoms and complications
The important symptoms of TNDD-China are heartburn, reflux, difficulty swallowing. Atypical symptoms: chest pain, feeling of choking, salivation in the throat, chronic cough, asthma, hoarseness, sinusitis, hiccups

... are often caused by complications of TNDD-China
The most common complication is reflux esophagitis (IUD) with ulcerative, atrophy consequences.



Fibrosis due to inflammation can shrink the esophagus.
The esophageal mucosa is shortened because the esophageal mucosa is gradually replaced by the gastric mucosa (Barrett mucosal metaplasia) with the risk of metastatic mucosal adenocarcinoma.
Esophageal ulcers can cause CSR. More rarely are complications of laryngitis, sinusitis, nasopharyngitis, and reflux pneumonia occurring at night.
The important symptoms of gastroesophageal reflux are heartburn, reflux, difficulty swallowing
Treatment
Using the drug is the first choice in the treatment of gastroesophageal reflux. Esophagitis will heal in almost 90% of cases if actively treated with medication.
Mild cases may use drugs that increase the tonicity of CVDTQ such as Metoclopramide, Domperidone, Cisapride or Antacid, Alginic Acid
However, using the drug does not solve the cause of the disease, so symptoms will reappear in more than 80% of cases after 1 year of stopping the drug.




There are two clinical trials comparing drug and surgical treatments for TNDD-China, which have shown more bias-related results in improving symptoms and endoscopic signs for real inflammation. administered in patients with disease for more than 2 years.
The main goal of surgery in patients with TNDD-China is to reinforce the barrier against reflux without creating excessive side effects. In addition, most surgeons feel the need to:
• Ensure that the esophagus portion of the abdominal cavity is of appropriate length, allowing vertical fundoplication surgery and that there is no pressure around the distal end of the esophagus
• Use the base to help twist and perform fundoplication without pressure
• Correct defects in the esophagus
Esophagitis will heal in almost 90% of cases if actively treated with medication
Surgery is usually indicated in cases that do not respond or respond poorly to medical treatment. These are the methods of creating perineal folds (Nissen surgery, Toupet surgery), or the methods of endoscopic interventions (laparoscopic surgery with laparoscopy, biological injections to increase muscle mass).
Cases of esophageal stenosis may be dilated through laparoscopy..

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