The effectiveness and cost-effectiveness of minimal access surgery amongst people with gastro-oesophageal reflux disease – a UK collaborative study. The REFLUX trial

Grant, Adrian; Wileman, Samantha; Ramsay, Craig R; Bojke, Laura; Epstein, David; Sculpher, Mark; Macran, Susan; Kilonzo, Mary; Vale, Luke; Francis, Julie; Mowat, Ashley G; Krukowski, Z. H.; Heading, R C; Thursz, Mark; Russell, Ian; Campbell, Marion K

doi:10.3310/hta12310

Cited by 82 publications

(92 citation statements)

References 4 publications

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“…Comment: In Western countries, comparative studies on the cost-effectiveness of both treatments have been performed [151], but it has not been sufficiently investigated in Japan [152]. In an RCT comparing laparoscopic fundoplication and PPI treatment [152], it was suggested that the cost-effectiveness of laparoscopic surgery for GERD with long-term medication is better than that of medical therapy.…”

Section: (4) Enteric Infectionmentioning

confidence: 99%

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

et al. 2016

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As an increase in gastroesophageal reflux disease (GERD) has been reported in Japan, and public interest in GERD has been increasing, the Japanese Society of Gastroenterology published the Evidence-based Clinical Practice Guidelines for GERD (1st edition) in 2009. Six years have passed since its publication, and there have been a large number of reports in Japan concerning the epidemiology, pathophysiology, treatment, and Barrett's esophagus during this period. By incorporating the contents of these reports, the guidelines were completely revised, and a new edition was published in October 2015. The revised edition consists of eight items: epidemiology, pathophysiology, diagnosis, internal treatment, surgical treatment, esophagitis after surgery of the upper gastrointestinal tract, extraesophageal symptoms, and Barrett's esophagus. This paper summarizes these guidelines, particularly the parts related to the treatment for GERD. In the present revision, aggressive proton pump inhibitor (PPI) maintenance therapy is recommended for severe erosive GERD, and on-demand therapy or continuous maintenance therapy is recommended for mild erosive GERD or PPI-responsive non-erosive GERD. Moreover, PPI-resistant GERD (insufficient symptomatic improvement and/or esophageal mucosal break persisting despite the administration of PPI at a standard dose for 8 weeks) is defined, and a standard-dose PPI twice a day, change in PPI, change in the PPI timing of dosing, addition of a prokinetic drug, addition of rikkunshito (traditional Japanese herbal medicine), and addition of histamine H2-receptor antagonist are recommended for its treatment. If no improvement is observed even after these treatments, pathophysiological evaluation with esophageal impedancepH monitoring or esophageal manometry at an expert facility for diseases of the esophagus is recommended.

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Section: (4) Enteric Infectionmentioning

confidence: 99%

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

et al. 2016

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“…Gastroesophageal reflux disease (GORD) is a common problem in western populations with high incidence and treatment costs [1,2]. The conservative medical treatment using proton pump inhibitors is the most effective noninvasive standard treatment [3].…”

Section: Introductionmentioning

confidence: 99%

Nissen versus Dor Fundoplication for Treatment of Gastroesophageal Reflux Disease: A Blinded Randomized Clinical Trial

Raue

Ordemann

Jacobi³

et al. 2011

Dig Surg

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Introduction: Fundoplication techniques for treatment of gastroesophageal reflux are discussed concerning impairments and success. This randomized trial was conducted to compare Nissen’s wrap and the anterior partial technique (Dor) concerning patients’ quality of life (QoL) and functional data after a mid-term follow-up. Methods: In a 24-month period, 64 patients were equally randomized into group A (Nissen’s fundoplication) and group B (180° anterior partial fundoplication). After a mean follow-up of 18 months, all patients were examined and interviewed using standardized QoL questionnaires (Gastrointestinal Quality of Life Index), Visick score, 24-hour pH-metry and esophageal manometry. Data of 57 patients (group A: 27, group B: 30) could be analyzed. Results: After partial fundoplication, 9 patients (30%) stated the operative results were worse than perfect. Only 2 patients (7%) evaluated the outcome after Nissen’s fundoplication as unsuccessful (p = 0.04). However, postoperative Gastrointestinal Quality of Life Index showed no differences between groups (p = 0.5). Additionally, functional data were not different (DeMeester 10 vs. 12, p = 0.17, and lower esophageal sphincter pressure 13 vs. 12 mm Hg, p = 0.5). Conclusion: The anterior partial fundoplication technique did not lead to disadvantages in postoperative QoL, physiological function and reflux control when compared to Nissen’s approach in a mid-term follow-up.

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“…In another recent randomised, controlled trial (REFLUX) including a total of 357 patients subjected to a 5-year follow-up, SF-scores and European Quality of Life-5 Dimensions scores were generally better after surgery. However, the differences attenuated over time and were not significant at five years [48].…”

Section: Comparison Of Quality Of Life In Patients Treated Pharmacolomentioning

confidence: 96%

Quality of life in patients with gastroesophageal reflux disease following pharmacotherapeutic, endoscopic, and surgical treatment

Jurkowska

Świdnicka-Siergiejko

Łagoda

et al. 2016

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Gastroesophageal reflux disease (GERD) is associated with bothersome symptoms. Their chronic and recurrent character has a negative impact on the physical and mental status of the patients. Improvement in health-related quality of life (HRQOL) of GERD patients along with decreasing the severity of symptoms remain the main aims of therapy. This paper reviews literature regarding HRQOL in GERD patients, as well as the impact of various treatment modalities on the patient's status, the incidence and severity of symptoms thereof, and subjective quality of life. Additionally, the factors that may influence the treatment outcome are also discussed. Several studies showed that the improvement of HRQOL is greater after surgical treatment than with pharmacological therapy. However, long-term studies are still needed to determine if surgery can constitute the equivalent of lifelong medical therapy. StreszczenieChoroba refluksowa przełyku (GERD) wiąże się z występowaniem uciążliwych objawów. Ich przewlekły i powtarzający się charakter negatywnie wpływa na stan fizyczny i psychiczny pacjentów. Poprawa jakości życia związanej ze zdrowiem (HRQOL) pacjentów z GERD oraz zmniejszenie nasilenia objawów są głównymi celami terapii. W pracy dokonano przeglą-du piśmiennictwa dotyczącego HRQOL u pacjentów z GERD, wpływu różnych metod leczenia na stan pacjentów, częstości występowania objawów i ich nasilenia oraz subiektywnej jakości ich życia. Dodatkowo omówiono czynniki, które mogą mieć wpływ na wyniki terapii. Wyniki wielu badań wykazały, że poprawa HRQOL jest większa po zabiegu chirurgicznym w porównaniu z terapią farmakologiczną. Nadal jednak potrzebne są długoterminowe badania, aby ustalić, czy zabieg chirurgiczny może stanowić odpowiednik terapii farmakologicznej.

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The effectiveness and cost-effectiveness of minimal access surgery amongst people with gastro-oesophageal reflux disease – a UK collaborative study. The REFLUX trial

Abstract: Current Controlled Trials ISRCTN15517081.

Cited by 82 publications

References 4 publications

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

Nissen versus Dor Fundoplication for Treatment of Gastroesophageal Reflux Disease: A Blinded Randomized Clinical Trial

Quality of life in patients with gastroesophageal reflux disease following pharmacotherapeutic, endoscopic, and surgical treatment

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