Endoscopic findings in patients with gastroesophageal reflux disease referred to antireflux laparoscopic surgery

Abstract

Background: Gastroesophageal reflux disease (GERD) is nowadays a highly prevalent, chronic condition, with 10% to 30% of Western populations affected by weekly symptoms. The patient who does not respond to the empiric antisecretory treatment, with alarming symptoms, or referred to surgery should undergo an esophagogastroduodenoscopy (EGD). Material and methods: This was a retrospective and descriptive study of patients with GERD admitted for antireflux laparoscopic surgery from 2012 to 2019. All endoscopic data were analyzed with the following variables: age, gender, reflux esophagitis and its severity, esophageal ulcers and strictures, Shatzky’s ring, Barrett’s esophagus (BE), incompetence of the esogastric junction; hiatal hernia. Results: A total of 152 patients were included in the study. The age of the patients ranged from 19 to 76 years, averaging 52 years. Among them, 97 (63.8%) were women and 55 (35.38%) men. A wide variety of endoscopic features has been found: non-erosive GERD (6.57%); reflux esophagitis (Savary-Miller) – I (21.05%), II (44.07%), III (23.68%); esophageal ulcer (1.31%), BE (1.97%). The majority of patients present axial hiatal hernia (92.76%) corresponding to Hill grade IV incompetence of the flap valve. Hill grade III was present in 4.6% of cases, grade II – 2.63%. Conclusions: The patients with GERD may have a wide range of endoscopic features (from normal to esophagitis, hiatal hernia, strictures and EB). Considering the multitude of data provided by endoscopic examination in patients with GERD, it can be certainly stated that EGD is one of the most important investigations in these patients, and is mandatory in those selected for surgical treatment.