The economics of laparoscopic Nissen fundoplication

Dire, Christopher A.; Jones, Michael P.; Rulyak, Stephen J.; Kahrilas, Peter J.

doi:10.1053/s1542-3565(03)00138-1

Cited by 2 publications

(2 citation statements)

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“…Die Überlegenheit von Antirrefluxeingriffen im Hinblick auf die Kosten ist bis heute nicht belegt. Analysen aus den USA sprechen gegen die Kosteneffektivität des operativen Vorgehens [10]. …”

Section: Operationswunsch Des Patientenunclassified

Gastroösophageale Refluxkrankheit: wirklich ein interdisziplinäres Krankheitsbild in der Viszeralmedizin?

Koop¹

2006

Visc Med

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The interdisciplinary approach of gastroenterologists and surgeons in the treatment of patients with gastro-oesophageal reflux disease is not adequately developed so far. When viewing typical clinical situations (conventional standard therapy, patient asking for antireflux surgery, therapeutic failures, patients with non-acid reflux, effects of antireflux therapy on malignant transformation in Barrett's oesophagus) it could be demonstrated that both disciplines contribute substantially to an optimal quality of treatment of reflux disease. Thus, a closer cooperation should be encouraged.

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Section: Operationswunsch Des Patientenunclassified

Gastroösophageale Refluxkrankheit: wirklich ein interdisziplinäres Krankheitsbild in der Viszeralmedizin?

Koop¹

2006

Visc Med

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“…However, no data are available to show that in fact the total societal-based cost for treatment and management of GERD has decreased during recent years. With the introduction of the laparoscopic approach to antireflux surgery, it is obvious that the cost estimates had to be changed [64,65]. Many studies have suggested that laparoscopic antireflux surgery is less costly than open surgery based on the fact that the number of days in hospital and on sick leave are reduced.…”

Section: Cost-effectiveness Of Antireflux Surgerymentioning

confidence: 99%

Surgery of Gastroesophageal Reflux Disease: A Competitive or Complementary Procedure?

Lundell

2004

Dig Dis

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The management of chronic gastroesophageal reflux disease (GERD) has both been simplified and immensely improved by the development of modern medical therapies. These are built entirely on the concept of profound acid inhibition, which is very successful in a substantial proportion of GERD patients. Despite the efficacy of proton pump inhibitors (PPIs) some failures are unavoidable, and some patients experience incomplete control of major GERD symptoms on ordinary dosing of PPIs. Although the safety profile of PPIs is very reassuring, some people express some concern about the safety of drug treatment extending beyond 10 years especially when alternative therapeutic strategies are available. Some patients complain of alleged respiratory complications to severe reflux, and in those situations as well as in cases with e.g. Barrett’s esophagus, a complete control of reflux also incorporating the duodenal components in the refluxate may be warranted. In all those situations antireflux surgery can be considered indicated for the treatment of chronic GERD and thus be looked upon as complementary to medical therapy. Furthermore, some patients who have their GERD symptoms under control on PPIs still want to have an operation to avoid dependency on drugs. Hence in none of these clinical situations does antireflux surgery play a competitive role in relation to medical therapy. However, in the very few randomized clinical trials in which a head-to-head comparison has been completed between medical and surgical therapy, the latter has been found to be somewhat more effective in terms of reflux control. The other side of the coin is that antireflux surgery has some side effects that signify the importance of this surgery being performed in specialized centers.

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The economics of laparoscopic Nissen fundoplication

Cited by 2 publications

References 0 publications

Gastroösophageale Refluxkrankheit: wirklich ein interdisziplinäres Krankheitsbild in der Viszeralmedizin?

Gastroösophageale Refluxkrankheit: wirklich ein interdisziplinäres Krankheitsbild in der Viszeralmedizin?

Surgery of Gastroesophageal Reflux Disease: A Competitive or Complementary Procedure?

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