Guidelines for Surgical Treatment of Gastro esophageal Reflux Disease (GERD)

In view of surgery, GERD is the failure of the antireflux barrier, allowing abnormal reflux of gastric contents into the esophagus. It is a mechanical disorder, which is caused by a defective lower esophageal sphincter (LES), a gastric emptying disorder, or failed esophageal peristalsis. These abnormalities result in a spectrum of disease ranging from symptoms only, such as "heartburn", to esophageal tissue damage with or without subsequent complications including malignancy or airway disease. While the exact nature of the antireflux barrier is not completely understood, the current view is that the LES, the diaphragmatic crura, and the phrenoesophageal ligament are key components.