Background and aim: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases facing society today. Assosciation of bronchial asthma with GERD is a common problem, we tried to evaluate the surgical treatment (reflux surgery) and its results to choose the patients who will get benefit from reflux surgery.
Patients and methods: We report the results of surgical repair of gastroesophageal reflux in
32 asthmatic patients who underwent surgery. The severe asthma was associated with clinically evident reflux, and repair was attempted by surgical techniqueNissentransabdominalgastropexy and laparoscopic fundoplication.
Results: Total cure, eight cases (25%); marked improvement, five (15.6%); moderate improvement, eight (25%); no improvement, 11 (34.4%).Cure was attained in intrinsic asthma with a predominance of nocturnal crises, associated with nocturnal tracheitis and with significant reflux, objective signs of which had appeared before the beginning ofthe asthma. Other results concerned asthmas complicated secondarily by GER in which it was impossible to determine whether the reflux was only a complication, without effect on the respiratory illness, or exacerbating the asthma.
Conclusions: The question of surgery in these patients should be considered with care, being reserved for cases of severe asthma, poorly controlled by antiasthmatic drugs, and complicated by a severe reflux that encompasses ulcerative esophagitis. The majority of patients in most studies seem to improve symptomatically after surgery. However, a small percentage remains unchanged or worsens. The reported studies are so disparate in their methodology that firm conclusions on the role of surgery are difficult. Further studies are needed