J.Jpn. Surg. Soc.. 98(11): 947-952, 1997

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Feature topic

RECENT ADVANCES IN ANTIREFLUX SURGERY FOR GASTROESOPHAGEAL REFLUX DISEASES－FROM OPEN SURGERY TO LAPAROSCOPIC SURGERY－

Gastroesophageal reflux diseases (GERD) are common in the western countries and have been well studied about diagnosis and treatment. Nissen technique (a complete wrap) and Toupet technique (a partial wrap) are usually transabdominal fundoplication. Hill technique is a transabdominal posterior gastropexy. Allison technique is a transthoracic reduction method of the herniated cardia back into the abdomen, but is not frequently employed today. Belsey Mark VI technique is a tansthoracic anterior plication. Collis gastroplasty is an esophageal lenghening technique and is used with standard repairs (Nissen, Belsey, and Hill). Good result rate of above mentioned surgery are about 90％. Recently laparoscopic Nissen/Toupet technique are a standard antireflex surgery because of minimal invasiveness and more than 90％ of good results. After introducing laparoscopic surgery the indication of antireflex surgery for GERD can be changed because of quality of life of patients and medicoeconomical reasons.

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