Gastro-oesophageal reflux disease : studies in physiology and innovations in surgical management

Abstract

The work detailed in this thesis combined studies in surgical audit with assessment of outcomes relating to dysmotility, evaluated an innovative approach to quality assurance in surgery, explored new understandings of linked physiological mechanisms in GORD, specifically LPR and gastric function, and finally compared the clinical and physiological outcomes of the surgical standard of care with the Endocinch endotherapy technique. Defining Existing Standard of Care (Chapter 3): An 8 year experience of 378 Rosetti -Nissen fundoplications was performed. At a median follow-up of 6 months there was improved symptom scoring and QOL with an almost 90% patient satisfaction rate and physiological and clinical evidence of control of reflux.