Comparing Surgery and Medication for Chronic Reflux Disease
Author Information
Author(s): Lundell L, Attwood S, Ell C, Fiocca R, Galmiche J-P, Hatlebakk J, Lind T, Junghard O
Primary Institution: Karolinska University Hospital
Hypothesis
How does laparoscopic antireflux surgery compare to esomeprazole in treating chronic gastro-oesophageal reflux disease?
Conclusion
Both laparoscopic total fundoplication and continuous esomeprazole treatment were similarly effective and well-tolerated for controlling gastro-oesophageal reflux disease over three years.
Supporting Evidence
- 554 patients were randomised, with 288 undergoing surgery and 266 receiving medication.
- 90% of surgical patients and 93% of medically treated patients remained in remission after 3 years.
- Postfundoplication complaints were noted but did not significantly affect overall outcomes.
Takeaway
Doctors compared two ways to help people with bad heartburn: one was surgery, and the other was a daily medicine. Both worked pretty well after three years.
Methodology
This was a multicentre, randomised controlled trial comparing laparoscopic antireflux surgery and esomeprazole treatment over three years.
Potential Biases
Potential bias in patient selection and treatment allocation despite randomization.
Limitations
The study may not represent outcomes in less experienced surgical centers or in patients with more complex medical histories.
Participant Demographics
Mean age was 45 years, with a majority being male (69% for surgery, 75% for medical treatment).
Statistical Information
P-Value
0.25
Statistical Significance
p=0.25
Digital Object Identifier (DOI)
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