Anti-reflux surgery for controlling respiratory symptoms of gastro-esophageal reflux disease: A systematic review and meta-analysis

Tustumi, Francisco; Bernardo, Wanderley Marques; Rocha, Júlio Rafael Mariano da; Szachnowicz, Sérgio; Seguro, Francisco Carlos Bernal da Costa; Bianchi, E; Takeda, Flávio Roberto; Neto, Antônio Afonso de Miranda; Sallum, Rubens Antônio Aissar; Cecconello, Ivan

doi:10.1016/j.asjsur.2020.04.017

Cited by 17 publications

(18 citation statements)

References 72 publications

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“…The incidence of GERD in Western countries is 8-27% (13), and the incidence in China is 1.9-7.0% (14). Studies have shown standard doses of proton pump inhibitors (PPIs) once or twice daily were only partially effective or completely ineffective for 40% of GERD patients (15). It can only improve GERD symptoms, but not esophageal motor function (16).…”

Section: Introductionmentioning

confidence: 99%

Endoscopic treatment of cardia lesions: the effects on gastroesophageal reflux disease

Liu¹,

Li²,

Zhou³

et al. 2021

Ann Palliat Med

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Background: Drug treatment is the main form of management for patient with gastroesophageal reflux disease (GERD). However, long-term medication can increase the psychological burden of patients. Furthermore, in some patients, standardized drug treatments do not effectively control their condition.Traditional anti-reflux surgery has a low degree of acceptance due to its trauma and many associated complications. In contrast, endoscopic minimally invasive surgery is preferable. This study explored the effects of endoscopic treatment of cardia diseases on GERD.Methods: A retrospective analysis was conducted on 106 patients with cardia disease (including cardia polyp, precancerous lesion, and early cardia cancer) and reflux esophagitis (RE). Patients underwent endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD), and the rates of complete resection, postoperative complications, and postoperative reflux were assessed.Results: Among the 106 lesions, 104 lesions were completely resected, and 2 early cancers were cured. No delayed hemorrhage was detected in any of the cases. The GERD-HRQL (gastroesophageal reflux diseasehealth related quality of life) and GERD-Q (gastroesophageal reflux disease-questionnaires) scores decreased significantly at 3 and 6 months post-operation (P<0.001). Furthermore, the RE grade was significantly different before and after the operation (P<0.001). The basic cure rate at 3 and 6 months after the operation was 83.96% and 84.91%, respectively, and the significant remission rate was 10.38% and 8.49%, respectively.Conclusions: Endoscopic treatment of cardia conditions is advantageous due to low levels of trauma, higher complete resection rates, and fewer complications. Moreover, the fibrous scar generated after endoscopic treatment forms an anti-reflux barrier, which can alleviate or even cure RE to a certain extent.This may represent a promising method for the clinical treatment of GERD.

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Section: Introductionmentioning

confidence: 99%

Endoscopic treatment of cardia lesions: the effects on gastroesophageal reflux disease

Liu¹,

Li²,

Zhou³

et al. 2021

Ann Palliat Med

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“…A chronic cough is a serious problem for patients with GERD and has serious psychological and social consequences. According to the conducted studies, most people suffering from chronic cough described a negative impact on the quality of life, depression, social, and workplace shame [6,9]. Many patients complained of physical complications, such as chest pain, sleep disturbances, urinary incontinence, and vomiting [7,10].…”

Section: Discussionmentioning

confidence: 99%

“…Tutsumi et al conducted a meta-analysis of the results of anti-reflux surgery in GERD respiratory symptoms [9]. Of the 61 analyzed studies, only 44% concerned Nissen fundoplication, the rest involved different surgical techniques or a combination of them.…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Outcomes of Chronic Cough Reduction after Laparoscopic Nissen Fundoplication—A Single-Center Study

et al. 2021

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Background and Objectives: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases. It affects 20% of the adult population and is the third most common cause of chronic cough in adults. This study describes the results of LNF for the relief of GERD-related cough. Materials and Methods: The prospectively collected data on 135 laparoscopic LNF in our department from 2014 to 2018 were reviewed. During consultations, patients were asked about the frequency of symptoms using the GERD Impact Scale (GERD-IS), their satisfaction and recommendation to others, and their general condition after the procedure. Results: We analyzed 23 of 111 patients (20.7%) reporting chronic cough. The mean age was 47 years (range 27–76 years, ±13.9 years) and the mean follow-up time was 48.3 months (range 22.6–76.3 ± 18.05 months). Most patients reported relief from cough after the surgery (78.3%, p < 0.001). Five patients (22%) reported the recurrence of symptoms after a mean of 10.8 months (6–18 months). Seventeen patients (74%) would undergo the surgery again and 18 patients (78%) would recommend the surgery to their relatives. There was a statistically significant improvement in all symptoms from the GERD-IS (p < 0.05). Conclusions: LNF may play an important role in the management of GERD patients with extraesophageal symptoms. After LNF, most of the operated patients reported complete resolution of chronic cough and would recommend the procedure to their relatives.

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“…Beta-agonists decrease the esophageal sphincter retention pressure (Level 2b; Grade: B) (70). This phenomenon is usually seen as an adverse event for patients treating respiratory conditions, such as chronic obstructive pulmonary disease, favoring esophageal reflux episodes (71). One old study evaluated beta-agonists in achalasia patients and showed a reduction in esophageal sphincter pressure lasting over 90 min (Level 2b; Grade: B) (72).…”

Section: Beta-agonistsmentioning

confidence: 99%

Evaluating the Non-conventional Achalasia Treatment Modalities

Tustumi

2022

Front. Med.

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IntroductionAchalasia is a primary esophageal dysmotility disorder. Despite the high volume of studies addressing the conventional treatments for achalasia, few are debated regarding the non-conventional treatments, such as cardiectomy, cardioplasty, endoluminal substances injection (ethanolamine oleate, polidocanol, botulinum toxin), stents, and certain drugs (beta-agonists, anticholinergic, nitrates, calcium channel blockers, and phosphodiesterase inhibitors).MethodsA critical review was performed.ResultsEndoscopic, surgical, and pharmacological treatments were included. A qualitative synthesis was presented.ConclusionNon-conventional therapeutic options for treating achalasia encompass medical, endoscopic, and surgical procedures. Clinicians and patients need to know all the tools for the management of achalasia. However, several currently available studies of non-conventional treatments lack high-quality evidence, and future randomized trials are still needed.

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Anti-reflux surgery for controlling respiratory symptoms of gastro-esophageal reflux disease: A systematic review and meta-analysis

Cited by 17 publications

References 72 publications

Endoscopic treatment of cardia lesions: the effects on gastroesophageal reflux disease

Endoscopic treatment of cardia lesions: the effects on gastroesophageal reflux disease

Long-Term Outcomes of Chronic Cough Reduction after Laparoscopic Nissen Fundoplication—A Single-Center Study

Evaluating the Non-conventional Achalasia Treatment Modalities

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