Diagnostics and surgical treatment of atypical manifestation of gastroesophageal reflux disease
In 10% of patients with gastroesophageal reflux disease (GERD) typical symptoms are absent, and main symptoms are respiratory, cardiovascular and otolaryngological complaints.
Objective. To improve the diagnostical algorithm of detection of extraesophageal symptoms of the GERD, to assess the efficacy of laparoscopic fundoplication in patients with different types of gastroespohageal reflux (GER).
Matherials and methods. Quality of life (QL) assessment surveys SF–36 and GERD–HRQL were used to evaluate long–term results of conservative and surgical treatment of patients with respiratory and otolaryngological symptoms of GERD.
Results. More significant improvement of physical and psychological components of QL was detected in patients who underwent laparoscopic fundoplication. According to GERD–HRQL survey, QL of patients after surgery improved within 6 months from (16.4 ± 5.3) up to (6.2 ± 0.6) (р < 0.001), within 12 months – up to (6.4 ± 0.8) (р<0.001); after conservative treatment within 6 months – from (15.9 ± 6.6) up to (9.2 ± 1.9) (р < 0.001), within 12 months – up to (11.4 ± 1.5) (р < 0.05).
Conclusion. Laparoscopic fundoplication is more effective than the conservative treatment of patients with extraesophageal symptoms of GERD.
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