Antireflux surgery

a. Surgery is recommended only for patients who are resistant to or intolerant of medical therapy or who have complications of GERD (eg, recurrent aspiration esophageal stricture formation).

b. Antireflux surgery has shown disappointing long-term results, and is indicated only on rare occasions.

c. Nissen fundoplication is the most commonly used operation. The fundus is completely wrapped around the esophagus, and the hiatus is closed. The procedure is usually done laparoscopically.

References: See page 195.

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