Could a Low-Risk Surgery Help Chronic Heartburn?
Death rate from procedure lower than previously reported, study finds
By Maureen Salamon
TUESDAY, March 29, 2016 (HealthDay News) -- A minimally invasive surgery to treat chronic heartburn is safer than generally believed, and could be a desirable alternative to long-term use of acid reflux medications, new research indicates.
Scientists found the death rate following so-called laparoscopic fundoplication surgery for gastroesophageal reflux disease, or GERD, was far lower than the 1 percent often quoted.
Experts contended the surgery might be underutilized, especially in light of increasing safety concerns about acid reflux drugs.
"One of the main arguments against surgery when choosing between [drug] and surgical treatment for severe GERD is the risk of mortality," said study author Dr. John Maret-Ouda. He is a physician and doctoral student in upper gastrointestinal surgery at the Karolinska Institute in Sweden.
But, "this study found only one death associated with [this surgery] among nearly 9,000 patients ... during the study period of 1997 to 2013," he added.
The study results were published in a recent issue of the British Journal of Surgery.
GERD occurs when the muscle at the bottom of the esophagus doesn't close properly, allowing stomach acid to leak back up and cause irritation. The resulting chronic heartburn is uncomfortable, and can lead to cellular changes that develop into esophageal cancer. GERD affects up to 20 percent of people in the United States, according to the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.
Drugs known as proton pump inhibitors, or PPIs, can reduce stomach acid production. Brand names for such medications -- one of the top-selling drug classes in the United States -- include Prilosec, Prevacid and Nexium. But long-term use of such medications has been potentially linked to some serious health conditions, such as dementia.
Maret-Ouda and his team analyzed 30-day and 90-day death rates after laparoscopic fundoplication surgery for GERD among nearly 9,000 patients. The surgery, which uses several tiny incisions in the abdomen, detaches part of the stomach from the spleen and wraps it around the esophagus, forming a tighter barrier between the stomach and esophagus to prevent acid reflux.