Innovative Techniken in der Refluxchirurgie

Zusammenfassung

Potenzielle unerwünschte Wirkungen der PPI-Therapie (PPI: Protonenpumpeninhibitor) wie auch nicht immer zufriedenstellende Ergebnisse der etablierten Operationsmethoden führen aktuell zu steigendem Interesse an neuen chirurgischen Therapieverfahren zur Refluxtherapie. Die Technik und Ergebnisse der magnetischen Verstärkung (LINX^®) und der elektrischen Stimulation (EndoStim^®) des unteren ösophagealen Sphinkters werden dargestellt und diskutiert. Beide Verfahren sind wenig invasiv, prinzipiell reversibel und mit ermutigenden mittelfristigen Ergebnissen verbunden. Es wird damit eine erweiterte Indikation zur chirurgischen Therapie der gastroösophagealen Refluxkrankheit (GERD) angenommen. Dies birgt jedoch in Kombination mit der technischen Einfachheit der Verfahren das Risiko inadäquater Indikationen. Zur Gewinnung belastbarer Langzeitergebnisse wird die Etablierung eines verpflichtenden Registers vorgeschlagen.

Abstract

There is renewed interested in novel surgical procedures for GERD, as there are potential undesirable effects of PPI therapy and the results of the current surgical methods are not always satisfactory. The technique and results of magnetic enhancement (LINX^®) and electrical stimulation (EndoStim^®) of the lower oesophageal sphincter are presented and discussed. Both methods are less invasive, principally reversible and associated with encouraging mid-term results. It may therefore be an extended indication for the surgical treatment of gastroesophageal reflux disease. However, this, in combination with the technical simplicity of the procedures, carries the risk of inadequate indications. In order to obtain reliable long-term results, the establishment of a mandatory register is proposed.

Schlüsselwörter

GERD - Refluxchirurgie - LINX - EndoStim - Neurostimulator

Key words

GERD - reflux surgery - LINX - EndoStim - neurostimulator

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