Laparoscopic Nissen fundoplication and proton pump inhibitor (PPI) therapy are both established treatments for gastroesophageal reflux disease (GERD).
Dr Michael Rhodes and colleagues from England performed a prospective randomized study comparing these 2 treatments.
The research team evaluated 183 patients received either laparoscopic Nissen fundoplication or PPI therapy for GERD between 1997 and 2001.
In 2005, patients were followed up and asked to complete a reflux symptom questionnaire.
|Patients receiving surgery had further symptomatic improvement|
|Journal of Gastrointestinal Surgery|
The researchers randomized 91 patients to have surgery, and 92 to have optimized PPI therapy.
After 12 months, those who had been randomized to PPI were offered the opportunity to have surgery.
The research team reported that 54 patients went on to have antireflux surgery.
In all 3 groups, the team observed a significant improvement in symptom score after the initial 12 months.
However, those who had surgery despite receiving optimal PPI treatment experienced further symptomatic improvement at long-term follow-up.
Dr Rhodes' team concludes, “Both optimal PPI therapy and laparoscopic Nissen fundoplication are effective treatments for GERD.”
“However, surgery offers additional benefit for those who have only partial symptomatic relief whilst on PPIs.”