Health Technology Assessment Reports, 1983. Number 5. Anti-Gastroesophageal Reflux Implanation

摘要

This assessment will focus on anti-gastroesophageal reflux implantation. Surgical correction of hiatal hernia has always been a controversial subject. Not only are there numerous surgical techniques in use (i.e., no 'best' technique) but there is no consensus on indications for surgery. The symptoms can be relieved with medical management in the majority of patients (i.e., elevate head of bed, use liquid antacids, avoid cigarettes and alcoholic beverages). More resistant cases may require specific therapy like Urecholin or Cimetidine. For patients with symptoms resistant to medical management, there are several accepted surgical procedures. The procedures include: (a) the Hill procedure of posterior gastropexy, and (b) the Belsey and Missen procedures of fundoplication. Another procedure, the AARP, is a horseshoe-shaped device made of a silicone elastomer shell filled with a highly crosslinked silicone gel.