Brief Article
Copyright ©2014 Baishideng Publishing Group Co.
World J Gastroenterol. Jan 21, 2014; 20(3): 804-813
Published online Jan 21, 2014. doi: 10.3748/wjg.v20.i3.804
Table 1 Details of selected studies
Ref.Study designCountryDefinition of partial responseAge range (yr)n
Bais et al[7] Draaisma et al[8] Broeders et al[9]RCT 10-yr follow-up of LNF vs CNFNetherlandsBais et al: "…in patients with symptoms of GORD, insufficiently reacting to at least 40 mg of omeprazole daily, persisting oesophagitis, and pathological acid exposure, surgical treatment was proposed"… Broeders et al: "177 patients were included in a multi-center RCT to undergo Nissen fundoplication for PPI-refractory GERD"17-7979
Granderath et al[10]Prospective 5-yr follow-up of LTFAustria"All patients had a long history of GERD symptoms (mean 7.1 years; range 6 mo to more than 10 yr) and had been receiving medical treatment with PPI for a mean period of 18.4 ± 6.8 mo (20-60 mg omeprazole daily)"29-74155
Anvari et al[11]Prospective 5-yr follow-up of LF (one cohort of “poor responders”)Canada"Inadequate response (< 70% relief on a visual analogue scale, defined by the patient's subjective impression) to PPIs titrated to a dose of 120 mg/d in 445 patients"Not specified445
Jenkinson et al[12]Prospective 6-8-wk follow-up after LFUnited Kingdom"All patients were on long term acid-suppression therapy (at least 4 mo) with PPIs and were either symptomatic or dissatisfied with the treatment"20-7870
Mahon et al[13] Mehta et al[14]RCT 7-yr follow-up of LF vs PPI in GERD (PR subset)United KingdomMehta et al: "patients with symptoms of GERD for at least 6 mo" with "3 mo minimum of PPI maintenance therapy"..."After 12 mo, those who had been randomized to PPI were offered the opportunity to have surgery"26-6954
Pessaux et al[15]Retrospective 5-yr follow-up of LFFrance"The indications for surgery were intractable or recurrent symptoms due to GERD after an adequate trial (minimum of 3 mo) of conservative treatment that consisted of proton pump inhibitors (n = 1234; 92.1%)"18-861340
Ciovica et al[16]Prospective 12-mo follow-up of LFAustria"Antireflux surgery was indicated and performed in patients with persistent or recurrent GERD symptoms and/or complications despite maximal conservative treatment, and in patients preferring surgery to medical treatment"16-81351
Dallemagne et al[17]Prospective 5- and 10-yr follow-up of LF questionnairesBelgium"All patients were taking PPIs for acid suppression" … "For all patients, the primary symptoms indicating surgery were heartburn, associated with regurgitation in 54% and dysphagia in 8% of the patients"10-78100
Draaisma et al[18]RCT 6-mo follow-up of robot-assisted vs standard laparoscopy LFNetherlands"Surgical treatment was proposed for patients with GORD insufficiently reacting to proton pump inhibitors..."20-7450
Zehetner et al[19]Prospective 5-yr follow-up of LTFSwitzerlandAll patients diagnosed with GERD according to SAGES criteria; "98% received a pre-operative medical treatment for > 3 mo with PPI/H2-blockers and/or prokinetic"27-81100
Antoniou et al[20]Prospective 1-yr follow-up of LNFGreece“Continuous doses of PPIs for a minimum period of 6 mo incurred no or only partial relief of their symptoms. More specifically, refractory GERD symptoms to a standard dose of PPIs (omeprazole 20 mg/d) for at least 4 mo were followed by a therapeutic trial with a double dose of PPIs (omeprazole 40 mg/d) for 8-10 wk. Patients not responding to the high-dose PPI treatment were included in the study"17-6532
Brillantino et al[21]Prospective 1-yr follow-up of LNFItaly"…patients referred for symptomatic gastroesophageal reflux poorly responsive to standard dose PPI therapy…" "...persisting heartburn or regurgitation during treatment for at least 3 mo with omeprazole at 40 mg or lansoprazole at 30 mg/d…"18-7035
Broeders et al[22]Prospective 1-yr follow-up of LNFNetherlands"Thirty-one patients with PPI-refractory GORD with pathological acid exposure on pH monitoring…"26-6731
Frazzoni et al[23]Prospective 3-mo follow-up of EsophyX vs LNFItaly" patients referred to our centre because of troublesome heartburn/regurgitation persisting despite at least 4-wk high-dose PPI therapy"“Adults”10
Table 2 Endoscopy-proven esophagitis scores (Los Angeles classification[24])
Bais et al[7]2917711571No follow-up data presented
Granderath et al[10]1241552428160No follow-up data presented
Draaisma et al[18]14111333446 mo431246
Brillantino et al[21]1021 (A or B)4 (C or D)3512 mo34100035
Broeders et al[22]168421316 mo25320030