Wednesday, November 26, 2008

Relief from GERD, once and for all

Survey shows antireflux surgery is an effective treatment for GERD

Finally, good news for patients who have chosen not to have surgery to treat their gastroesophageal reflux disease (GERD) because they doubted surgery’s effectiveness. A new study reveals the benefits of a simple procedure that can vastly improve their quality of life. And, even better, the relief offered by this surgery is lasting and doesn’t require the hassle and expense of taking proton pump inhibitors (PPIs) and other prescription and over-the-counter drugs.

A new survey of 200 patients who underwent primary laparoscopic fundoplication, or antireflux surgery, at the Massachusetts General Hospital Digestive Healthcare Center over a 10-year period showed respondents had such positive results from the surgery that they reported near-normal GERD-related quality-of-life scores. Such scores are used to measure the health and well-being of GERD patients by asking them to assess the discomfort they experience when they eat certain foods, as well as the impact their GERD symptoms have on their sleep and general happiness.

The survey also revealed the surgery’s remarkable success rates. Respondents’ re-operation rate was less than 1.2 percent, and 71 percent of those surveyed expressed considerable satisfaction with their long-term outcome. “This study bolsters the argument that surgery is a very effective alternative to ongoing medical therapy,” says David Rattner, MD, chief of General and Gastrointestinal Surgery at MGH and senior author of the report.

The study confirms the surgery’s significant benefits and refutes conflicting medical literature that suggests medical treatment is preferable to surgery. These new results only reflect outcomes at Mass General, and those possible when an experienced surgical team performs the procedure over a significant period of time.   

Mass General’s Digestive Healthcare Center clearly offers the level of expertise necessary to make a successful outcome likely. The hospital was the first center in New England to perform laparoscopic antireflux surgery in 1991. And the Digestive Healthcare Center continues to be a leader in its field. Its expertise was recognized in 2005 by U.S. News and World Report, which ranked Mass General number 4 nationally in the treatment of digestive disorders.  

Measuring patient satisfaction is important because it is a key factor in choosing treatment options, particularly for GERD. The connection between GERD and the heightened risk for esophageal cancer, while important, is not enough to influence a patient’s decision to have surgery in most cases. Only 5 to 10 percent of patients with GERD develop Barrett’s esophagus, which occurs when cells of the lower esophagus are damaged by acid reflux and puts them at a slightly elevated risk for developing esophageal cancer. “The risk of esophageal cancer is actually very low," Dr. Rattner says.  

What is significant for patients is the possibility of finally achieving relief from GERD through the treatments available at the Digestive Healthcare Center’s new Barrett’s Esophagus Program. Patients benefit from the individualized approach offered by the program’s multidisciplinary team of nurse coordinators, diagnostic technicians, medical experts and highly skilled surgeons, who are all devoted exclusively to treating patients with GERD and Barrett’s Esophagus. Such patient-driven care is in keeping with the study’s findings, which suggest the best outcomes are dependent on proper patient selection and the use of specialized surgical techniques. “Our results let us say that, when this surgery is performed by an expert surgical team at a high-volume center, the outcome for patients is excellent,” says Dr. Rattner.

Back to Top