Document Detail

Maintenance therapy: is there still a place for antireflux surgery?
MedLine Citation:
PMID:  1348594     Owner:  NLM     Status:  MEDLINE    
Effective and safe maintenance medical therapy for uncomplicated reflux esophagitis is now feasible with omeprazole and it is likely that other H+K+ATPase blockers, and possibly very high dose H2 receptor antagonist regimens, will also be acceptable. In addition, many patients with ulceration, strictures, and Barrett's esophagus will respond to conservative medical therapy and a proportion of patients with erosive esophagitis may remain in remission with cisapride or with low dose H2 receptor antagonists, if disease is less severe. Thus, there is now a medical "gold standard" against which surgical therapy for uncomplicated esophagitis must be judged and it is essential that all future studies be conducted with clearly defined criteria for the assessment of the symptoms and endoscopic signs of esophagitis and its complications. As ever, the patient's wishes are paramount, but he or she must be allowed to select his or her therapy on the basis of a balanced and fully informed assessment of the long-term and short-term risks of all therapeutic modalities. The burdensome prospect of lifelong tablet ingestion and its potential dangers must be weighed against the alternative, in up to 30% of cases, that surgery may produce dysphagia, gas bloat, or dumping with no guarantee of a long-term cure.
D Armstrong; M Nicolet; P Monnier; G Chapuis; M Savary; A L Blum
Related Documents :
9127624 - Long-term management of gastroesophageal reflux disease and its complications.
17151804 - Use of acid suppressive medications after laparoscopic antireflux surgery: prevalence a...
7364314 - Outlook with conservative treatment of peptic oesophageal stricture.
12134614 - Barrett's esophagus: surveillance and treatment.
24481084 - An experimental model of urethral stricture in rabbits using holmium laser under urethr...
23083434 - A cementless, elastic press-fit socket with and without screws.
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  World journal of surgery     Volume:  16     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:    1992 Mar-Apr
Date Detail:
Created Date:  1992-05-13     Completed Date:  1992-05-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  300-7     Citation Subset:  IM    
Department of Otorhinolaryngology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Adenosine Triphosphatases / antagonists & inhibitors,  therapeutic use
Gastroesophageal Reflux / drug therapy*,  surgery*
H(+)-K(+)-Exchanging ATPase
Histamine H2 Antagonists / therapeutic use
Omeprazole / therapeutic use
Piperidines / therapeutic use
Serotonin Antagonists / therapeutic use
Reg. No./Substance:
0/Histamine H2 Antagonists; 0/Piperidines; 0/Serotonin Antagonists; 73590-58-6/Omeprazole; 81098-60-4/Cisapride; EC 3.6.1.-/Adenosine Triphosphatases; EC ATPase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Genomic analysis of Theileria sergenti stocks in Japan with DNA probes.
Next Document:  Preliminary human trial of inactivated golden hamster kidney cell (GHKC) vaccine against haemorrhagi...