Austrian experiences of antireflux surgery.

Abstract

Antireflux surgery (ARS) is a well established treatment for GERD (gastroesophageal reflux disease). The present study gives an overview of experience in Austria regarding the frequency of open and laparoscopic ARS and how Austrian departments meet the requirements for surgery. A questionnaire was sent to 115 surgical departments in Austria to evaluate in how many institutions antireflux surgery (open and/or laparoscopically) was performed since 1990, and which pre- and postoperative tests were obligatory, optional, or not performed. Units were divided into specialized and nonspecialized. The laparoscopic approach has gained in importance by about 300% in the past 5 years in the few hospitals performing this procedure. Esophageal manometry and 24-h pH monitoring were rarely done in nonspecialized units, despite the fact that GERD is mainly a functional disorder of the esophagus and stomach. In contrast to the nonspecialized units, the specialized unit performed upper endoscopy, esophageal manometry and 24-h esophageal pH monitoring as obligatory tests. ARS, both open and laparoscopic, is not commonly performed in surgical departments in Austria but the frequency has significantly increased in recent years. Laparoscopic ARS is a safe procedure in hospitals performing this frequently. Laparoscopic ARS should only be performed in specialized units with significant experience in gastroesophageal diseases, where functional testing of the esophagus can be done.