| Maintenance therapy: is there still a place for antireflux surgery? | |
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MedLine Citation:
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PMID: 1348594 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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D Armstrong; M Nicolet; P Monnier; G Chapuis; M Savary; A L Blum |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: World journal of surgery Volume: 16 ISSN: 0364-2313 ISO Abbreviation: World J Surg Publication Date: 1992 Mar-Apr |
Date Detail:
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Created Date: 1992-05-13 Completed Date: 1992-05-13 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7704052 Medline TA: World J Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 300-7 Citation Subset: IM |
Affiliation:
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Department of Otorhinolaryngology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine Triphosphatases
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antagonists & inhibitors,
therapeutic use Cisapride Gastroesophageal Reflux / drug therapy*, surgery* H(+)-K(+)-Exchanging ATPase Histamine H2 Antagonists / therapeutic use Humans Omeprazole / therapeutic use Piperidines / therapeutic use Serotonin Antagonists / therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Histamine H2 Antagonists; 0/Piperidines; 0/Serotonin Antagonists; 73590-58-6/Omeprazole; 81098-60-4/Cisapride; EC 3.6.1.-/Adenosine Triphosphatases; EC 3.6.1.10/H(+)-K(+)-Exchanging ATPase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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