One of the goals of antireflux surgery (ARS) is to lower the use of medication for heartburn symptoms. However, it is not clear whether surgery accomplishes this.
There is little data comparing the medication usage in patients with gastroesophageal reflux disease (GERD) who are treated nonoperatively, with those treated surgically.
There is also no data on subsequent esophageal procedures, such as upper endoscopy or dilation.
In this study, Dr Vic Velanovich from Detroit, Michigan, assessed any differences by comparing matched groups of medically and surgically treated patients.
- surgery group = 13%
- medication group = 95%
|Surgical Laparoscopy, Endoscopy and Percutaneous Techniques|
Dr Velanovich included all patients who underwent ARS with at least 1 year of follow-up.
The 122 patients were matched to 122 medically treated patients for gender, age, and month of surgery to month of gastroenterologic clinic visit.
Dr Velanovich gathered information using medical records or direct contact for the present use of medications and additional esophageal procedures related to GERD.
Dr Velanovich found that medication usage occurred in 13% of the ARS patients, compared with 95% of the medical patients.
Furthermore, ARS patients had used 359 patient-months of medication, compared with 3578 patient-months in the medical group.
It was also found that only 25% of the ARS patients who were prescribed medications actually responded to their use.
Overall, 9% of the ARS patients underwent additional procedures, compared with 64% of the medical patients.
Dr Vic Velanovich concluded, "ARS leads to decreased medication use and to decreased use of subsequent esophageal procedures".
"In addition, most postoperative ARS patients placed on medications do not respond, and therefore require an objective evaluation for their symptoms".