Honcharenko P. S., Shatkovskyi O. R., Тkachuk O. V., Kebkalo А. В.

EFFECTIVENESS OF SURGICAL TREATMENT OF REFRACTORY GASTROESOPHAGEAL REFLUX DISEASE

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About the author:

Honcharenko P. S., Shatkovskyi O. R., Тkachuk O. V., Kebkalo А. В.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Gastroesophageal reflux disease (GERD) is one of the most common pathologies of the gastrointestinal tract, affecting up to 20% of the adult population in developed countries. The main method of its treatment is the use of proton pump inhibitors (PPIs), which can achieve symptom control in most cases. At the same time, about one-third of patients develop resistance to PPIs, which significantly reduces their quality of life and complicates medical treat ment. For such patients, surgery, in particular laparoscopic Nissen fundoplication, is considered the “gold standard” of treatment. However, the effectiveness of this approach in the long term, its safety and prognostic factors remain the subject of scientific debate. The aim of this study was to evaluate the results of treatment of patients with refrac tory gastroesophageal reflux disease and to identify predictors of therapeutic efficacy. This retrospective study analyzed the results of laparoscopic treatment of GERD in patients with PPI refractori ness (n=273). It was found that the Toupé fundoplication method is accompanied by a lower incidence of complications (χ²=33.89, p<0.005, α=0.05), in particular, dysphagia (χ²=4.32, p=0.038, α=0.05) and gas formation (χ²=6.45, p=0.011, α=0.05), compared to the Nissen method. The choice of surgical approach should be based on individual patient characteristics, the effectiveness of reflux control, and the risk of complications. Further prospective random ized trials are needed to clarify long-term results and create clear clinical recommendations for the optimal choice of fundoplication method.

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Bibliography:

1. Antunes C, Aleem A, Curtis SA. Gastroesophageal Reflux Disease. Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www. ncbi.nlm.nih.gov/books/NBK441938/.
2. Gyawali CP, Yadlapati R, Fass R, Katzka D, Pandolfino J, Savarino E, et al. Updates to the modern diagnosis of GERD: Lyon consensus 2.0. Gut. 2024;73(2):361-371. DOI: 10.1136/gutjnl-2023-330616.
3. Azer SA, Hashmi MF, Reddivari AKR. Gastroesophageal Reflux Disease (GERD). Treasure Island (FL): StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554462/.
4. Naik RD. Overview of Refractory Gastroesophageal Reflux Disease. Gastroenterol Hepatol (N Y). 2022;18(8):474-476.
5. Davis TA, Gyawali CP. Refractory Gastroesophageal Reflux Disease: Diagnosis and Management. J Neurogastroenterol Motil. 2024;30(1):17-28. DOI: 10.5056/jnm23145.
6. Zerbib F, Bredenoord AJ, Fass R, Kahrilas PJ, Roman S, Savarino E, et al. ESNM/ANMS consensus paper: Diagnosis and management of refractory gastro-esophageal reflux disease. Neurogastroenterol Motil. 2021;33(4):e14075. DOI:10.1111/nmo.14075.
7. Katz PO, Dunbar KB, Schnoll-Sussman FH, Greer KB, Yadlapati R, Spechler SJ. ACG Clinical Guideline for the Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol. 2022;117(1):27-56. DOI: 10.14309/ajg.0000000000001538.
8.  Slater BJ, Collings A, Dirks R, Gould JC, Qureshi AP, Juza R, et al. Multi-society consensus conference and guideline on the treatment of gastroesophageal reflux disease (GERD). Surg Endosc. 2023;37(2):781-806. DOI: 10.1007/s00464-022-09817-3.
9. Naik RD, Meyers MH, Vaezi MF. Treatment of Refractory Gastroesophageal Reflux Disease. Gastroenterol Hepatol (N Y). 2020;16(4):196-205.
10. McKinley SK, Dirks RC, Walsh D, Hollands C, Arthur LE, Rodriguez N, et al. Surgical treatment of GERD: systematic review and meta analysis. Surg Endosc. 2021;35:4095-4123 DOI: https://doi.org/10.1007/s00464-021-08358-5.
11.  Alonso Batanero E, Rodríguez Uría R, Amoza Pais S, Rodicio Miravalles JL, Moreno Gijón M, Sanz Navarro S, et al. Review of 5 years results after surgery for gastro-oesophageal reflux disease: nissen vs toupet. British Journal of Surgery. 2021;108(3):znab160.046, DOI:https://doi.org/10.1093/ bjs/znab160.046.

Publication of the article:

«Bulletin of problems biology and medicine», Issue 2,177, 152-157 pages, index UDC 616.33-008.1:616.329-008.22-089-085.242.4

DOI:

10.29254/2077-4214-2025-2-177-152-157