This multi-authored text provides information on the pathophysiology of Gastroesophageal Reflux Disease (GERD), appropriate medical management, and proper indications for and performance of surgical and endoscopic procedures.

The Editors look at the current understanding of this disease, and present new information regarding tissue susceptibility, the role of bile and digestive enzymes, and cyclic changes in LES tone. Chapters are devoted to standard therapeutic options for GERD, including lifestyle changes, pharmacologic therapy, and surgery. In addition, newer endoscopic treatments including Stretta, Endocinch, injection of bulking agents, as well as others, are described.

Failed Anti-Reflux Therapy: Analysis of Causes and Principles of Treatment is essential to any physician who manages patients with GERD, including internists, gastroenterologists, general surgeons, and thoracic surgeons.

Autorentext
Dr. P. Marco Fisichella is an expert in Minimally Invasive Gastrointestinal, Esophageal, and Bariatric Surgery. Executive Director with over 12 years experience in patient care, clinical research, and higher education. Strong leadership and project management skills coupled with demonstrated ability to achieve profitable growth. Have directed:
• The Surgical Services at Jamaica Plains, Boston VA Healthcare System, with a volume of 63,000 clinic visits per year.
• A $4.5M Simulation Center at Loyola University Stritch School of Medicine
• The Surgical Subspecialty Clinics at Hines Jr. VA Medical Center with a volume of 85,000 clinic visits per year
• The Swallowing Center at Loyola University Medical Center.

Zusammenfassung

This multiauthored text provides information on the pathophysiology of GERD, appropriate medical management, and proper indications for and performance of surgical and endoscopic procedures for GERD. Thousands of patients will experience inadequate relief from medical therapy or will develop complications from their procedures or recurrent or new symptoms afterwards; this text describes in detail the proper evaluation and management of such patients.

Beginning with an overview of the current understanding of the pathophysiology of GERD, the book moves onto new information regarding tissue susceptibility, the role of bile and digestive enzymes, and cyclic changes in LES tone. The next chapters are devoted to standard therapeutic options for GERD, including lifestyle changes, pharmacologic therapy, and surgery. In addition, newer endoscopic treatments, such as Stretta, Endocinch, injection of bulking agents, as well as others, are described. Subsequent chapters focuson the causes for failure of medical, endoscopic, and surgical therapies. The remainder of the text is a detailed examination of medical, endoscopic, and surgical remedies for these treatment failures.

This text is essential to any physician who manages patients with GERD, including internists, gastroenterologists, general surgeons, and thoracic surgeons.

Inhalt

History of medical and surgical antireflux therapy.- Establishing the diagnosis of GERD.- Medical management of gastroesophageal reflux disease: algorithms and outcomes.- Principles of successful surgical antireflux procedures.- Diagnosis and treatment of the extraesophageal manifestations of gastroesophageal reflux disease.- Acute complications of antireflux surgery.- Management of complications after paraesophageal hernia repair.- Persistent symptoms after antireflux surgery and their management.- Technical surgical failures: presentation, etiology, and evaluation.-  Symptoms after antireflux surgery: everything is not always caused by surgery.- The medical and endoscopic management of failed surgical antireflux procedures.- Reoperation for failed antireflux surgery.- Management of the short esophagus.- Esophagectomy: indications, techniques, and outcomes.