When a well-trained, competent surgeon performs anti-reflux surgery in a patient presenting with heartburn and regurgitation, 80-95% of patients obtain satisfactory relief of their reflux symptoms once recovered from the operation and eating normally again.1-14 Unfortunately, this degree of success cannot be matched outside of surgical centers of excellence and some data indicate that failure rates at 1 year as high as 50-60% may occur in less-experienced surgical centers.15,16 Furthermore, even in the best of hands, some patients will symptomatically relapse over time,with approximately 15-25% or more of patients reexperiencing symptoms of GERD five or more years after surgery despite initial success being achieved.17,18 Given the hundreds of thousands of anti-reflux procedures performed in the last few years and the continued rapid increase in the number of these procedures being performed,14,19,20 and with most of these being performed outside of highly skilled surgical centers, the problem of persisting or recurrent reflux symptoms after surgery is indeed a common one that will continue to grow and challenge the team caring for patients with GERD for the foreseeable future.21-27
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Gastroesophageal reflux disease is the medical term for what we know as acid reflux. Acid reflux occurs when the stomach releases its liquid back into the esophagus, causing inflammation and damage to the esophageal lining. The regurgitated acid most often consists of a few compoundsbr acid, bile, and pepsin.