MADRID, 31 (EUROPA PRESS)
Carrying out a preoperative functional study is essential in gastroesophageal reflux disease (GERD). This study is carried out through two tests, pHmetry and gastroesophageal manometry, explained Dr. Teresa Sánchez Rodríguez, specialist in General Surgery and the Digestive System and expert in gastroesophageal surgery at the Quirónsalud San José Hospital.
Gastroesophageal reflux disease is defined as all those symptoms and signs that occur due to excessive contact of gastric contents with the esophageal mucosa and should not be confused with gastroesophageal reflux, which is a physiological phenomenon that occurs daily in all people by the passage of gastric contents through the cardia into the esophagus.
The prevalence of GERD is high, according to the ‘Updating Document of the Clinical Practice Guideline on Gastroesophageal Reflux Disease in Adults’ of the Spanish Society of Gastroenterology, (2019), in Spain 9.8% of the population manifests typical GERD symptoms one or more times a week.
“In many cases,” says Dr. Sánchez Rodríguez, “it is necessary to decide whether to opt for pharmacological or surgical treatment, and in this case there are two essential variables: early diagnosis and preoperative functional study (through pHmetry and esophageal manometry). ), which offers crucial information about the number of reflux episodes and the functionality of the esophagus and, based on the results, decide what type of treatment to apply to each patient, adapting the surgical technique where appropriate. In addition to gastroscopy and in certain cases, the imaging study of gastroesophageal transit”.
Surgical treatment is generally resorted to when pharmacological treatment does not achieve complete relief of the symptoms, due to the side effects it entails or in the case of patients who do not wish to take medication for life, as well as anatomical alterations or aggravation of the disease that requires surgical treatment for its solution.
The gold standard procedure for treating reflux is called fundoplication, a technique in which a fold or twist is created in the upper part of the stomach (fundus) to improve the muscle tone of the cardia, preventing reflux. In addition, anatomical alterations that may be the cause of reflux, such as hiatal hernia, are corrected.
When deciding which type of surgery to opt for, there are several possibilities: minimally invasive options, which perform fundoplication through laparoscopy and endoscopy, provide several advantages such as reduced pain, a shorter hospital stay and almost immediate return to life. usual, in addition to a better aesthetic result.
“The laparoscopic route is the most complete for the definitive repair of the anatomical defect and the reinforcement of the cardia according to the needs of each patient,” says the expert, “and allows the performance of fundoplication in 360 or 180 degrees to be individualized in each case. In addition, “It would also be the route of choice in patients who do not correct their disease with endoscopic techniques or in patients with obesity to which bariatric surgery is added.”
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