Antireflux Surgery in Korea: A Nationwide Study from 2011 to 2014

Abstract

Background/AimsAlthough 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.MethodsData from 2011 to 2014 were collected from the Korean Antireflux Surgery Study Group and then analyzed.ResultsA 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%.ConclusionsThis 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.

Multicenter Prospective Study of Laparoscopic Nissen Fundoplication for Gastroesophageal Reflux Disease in Korea

“…The results reported that laparoscopic fundoplication is an efficient treatment method for controlling GERD symptoms. 3 Complete symptom control rates for typical and atypical symptoms were 86.3% and 63.3%, respectively. 3 Park et al 2 reported the largest laparoscopic Nissen fundoplication data at a single institution in Korea; the complete control rate was 88.5% and the pre-operative response to PPI medication was the most important factor in determining the outcome of surgery.…”

“…Although the number of operations is much less than the number of operations in the Western countries, there have been several reports on the outcomes of anti-reflux surgery in Korea. [2][3][4][5] The Korean anti-reflux surgery study group (KARS) conducted a nationwide survey among surgeons in Korea and reported the outcome of anti-reflux surgery in 87 patients. The results reported that laparoscopic fundoplication is an efficient treatment method for controlling GERD symptoms.…”

“…All previous reports in Korea were of a retrospective case series nature. [2][3][4][5] There has been no prospective study to date. The present study was the first multicenter prospective study evaluating the outcome of laparoscopic anti-reflux surgery in Korea.…”

“…Improvement or resolution of GERD symptoms by anti-reflux surgery in this study was almost the same as that reported in previous studies. 2,3,11 Symptomatic improvement after anti-reflux surgery was different for different types of GERD symptoms. Almost all patients had typical symptoms and at the same time, most had atypical symptoms.…”

“…Despite this, the number of anti-reflux surgeries in Korea has recently increased, and there have been several studies reporting the outcome of anti-reflux surgery. [2][3][4][5] However, there are no prospective studies comparing the efficacy of anti-reflux surgery and its effect on quality of life (QOL) with medical treatment.…”