Antireflux Surgery in Korea: A Nationwide Study from 2011 to 2014
0
조회
0
다운로드
5
인용
0
참고문헌
키워드
초록
Background/Aims: Although laparoscopic fundoplication is a well-established therapy for gastroesophageal reflux disease (GERD) in Western countries, the mainstay of GERD treatment in Korea is long-term proton pump inhibitor (PPI) use. The aim of the present study was to evaluate nationwide data regarding antireflux surgery in Korea. Methods: Data from 2011 to 2014 were collected from the Korean Antireflux Surgery Study Group and then analyzed. Results: A total of 87 patients underwent laparoscopic fundoplication for the treatment of GERD. Preoperatively, typical symptoms were present in 81 patients (93%) and atypical symptoms were present in 51 patients (59%). Twenty-seven patients (31%) had poor PPI responses. The average surgical time and postoperative hospital stay were 116.3±42.3 minutes and 4.3±3.1 days, respectively. At 3 months after surgery, typical symptoms were completely controlled in 86.3% of patients and partially controlled in 11.7%, whereas atypical symptoms were completely controlled in 63.3% of patients and partially controlled in 23.3%. Conclusions: This study showed that although atypical symptoms and PPI nonresponders are common, the complete control rates of typical and atypical symptoms were 86.3% and 63.3%, respectively. Laparoscopic fundoplication is an efficacious method of controlling the symptoms of GERD and has an acceptable rate of postoperative morbidity and adverse symptoms.
Abstract
Background/Aims: Although laparoscopic fundoplication is a well-established therapy for gastroesophageal reflux disease (GERD) in Western countries, the mainstay of GERD treatment in Korea is long-term proton pump inhibitor (PPI) use. The aim of the present study was to evaluate nationwide data regarding antireflux surgery in Korea. Methods: Data from 2011 to 2014 were collected from the Korean Antireflux Surgery Study Group and then analyzed. Results: A total of 87 patients underwent laparoscopic fundoplication for the treatment of GERD. Preoperatively, typical symptoms were present in 81 patients (93%) and atypical symptoms were present in 51 patients (59%). Twenty-seven patients (31%) had poor PPI responses. The average surgical time and postoperative hospital stay were 116.3±42.3 minutes and 4.3±3.1 days, respectively. At 3 months after surgery, typical symptoms were completely controlled in 86.3% of patients and partially controlled in 11.7%, whereas atypical symptoms were completely controlled in 63.3% of patients and partially controlled in 23.3%. Conclusions: This study showed that although atypical symptoms and PPI nonresponders are common, the complete control rates of typical and atypical symptoms were 86.3% and 63.3%, respectively. Laparoscopic fundoplication is an efficacious method of controlling the symptoms of GERD and has an acceptable rate of postoperative morbidity and adverse symptoms.
참고문헌 (20)
- 정혜경, "Epidemiology of Gastroesophageal Reflux Disease in Asia: A Systematic Review", Journal of Neurogastroenterology and Motility (JNM), 17(1), pp.14~27 (2011), 대한소화기 기능성질환∙운동학회
- Kim KM, "Prevalence of gastroesophageal reflux disease in Korea and associated health-care utilization: a national population-based study", J Gastroenterol Hepatol, 27, pp.741~745 (2012)
- Becher A, "Systematic review: the association between symptomatic response to proton pump inhibitors and healthrelated quality of life in patients with gastro-oesophageal reflux disease", Aliment Pharmacol Ther, 34, pp.618~627 (2011)
- Fass R, "Systematic review: protonpump inhibitor failure in gastro-oesophageal reflux disease: where next?", Aliment Pharmacol Ther, 22, pp.79~94 (2005)
- Dallemagne B, "Laparoscopic Nissen fundoplication: preliminary report", Surg Laparosc Endosc, 1, pp.138~143 (1991)
- Lundell L, "Seven-year follow-up of a randomized clinical trial comparing proton-pump inhibition with surgical therapy for reflux oesophagitis", Br J Surg, 94, pp.198~203 (2007)
- Mahon D, "Randomized clinical trial of laparoscopic Nissen fundoplication compared with proton-pump inhibitors for treatment of chronic gastro-oesophageal reflux", Br J Surg, 92, pp.695~699 (2005)
- Parrilla P, "Long-term results of a randomized prospective study comparing medical and surgical treatment of Barrett’s esophagus", Ann Surg, 237, pp.291~298 (2003)
- Spechler SJ, "Long-term outcome of medical and surgical therapies for gastroesophageal reflux disease: followup of a randomized controlled trial", JAMA, 285, pp.2331~2338 (2001)
- Galmiche JP, "Laparoscopic antireflux surgery vs esomeprazole treatment for chronic GERD: the LOTUS randomized clinical trial", JAMA, 305, pp.1969~1977 (2011)
- Vakil N, "The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus", Am J Gastroenterol, 101, pp.1900~1920 (2006)
- Viljakka M, "Incidence of antireflux surgery in Finland 1988-1993: influence of proton-pump inhibitors and laparoscopic technique", Scand J Gastroenterol, 32, pp.415~418 (1997)
- Stefanidis D, "Guidelines for surgical treatment of gastroesophageal reflux disease", Surg Endosc, 24, pp.2647~2669 (2010)
- Fernando HC, "Quality of life after antireflux surgery compared with nonoperative management for severe gastroesophageal reflux disease", J Am Coll Surg, 194, pp.23~27 (2002)
- 정혜경, "위식도역류질환 임상진료지침 개정안 2012", 대한소화기학회지, 60(4), pp.195~218 (2012), 대한소화기학회
- 이새별, "Early experiences of minimally invasive surgery to treat gastroesophageal reflux disease", 대한외과학회지, 84(6), pp.330~337 (2013), 대한외과학회
- 이상권, "Laparoscopic Nissen Fundoplication in Korean Patients with Gastroesophageal Reflux Disease", Yonsei Medical Journal, 50(1), pp.89~94 (2009), 연세대학교의과대학
- Campos GM, "Multivariate analysis of factors predicting outcome after laparoscopic Nissen fundoplication", J Gastrointest Surg, 3, pp.292~300 (1999)
- Auyang ED, "SAGES clinical spotlight review: endoluminal treatments for gastroesophageal reflux disease (GERD)", Surg Endosc, 27, pp.2658~2672 (2013)
- Liang WT, "Early and midterm outcome after laparoscopic fundoplication and a minimally invasive endoscopic procedure in patients with gastroesophageal reflux disease:a prospective observational study", J Laparoendosc Adv Surg Tech A, 25, pp.657~661 (2015)
