Secrets for successful laparoscopic antireflux surgery: patients with pulmonary diseases

Gastroesophageal reflux disease (GERD) has been associated to a spectrum of respiratory disorders such as idiopathic pulmonary fibrosis (IPF), asthma, and chronic obstructive pulmonary disease (COPD). Several factors including increased trans-diaphragmatic pressure gradient, flattening of the diaphragm, and medication side effects affecting relaxation of the lower esophageal sphincter have linked GERD with pulmonary diseases. While medical therapy alters the pH of the gastric juice, it does not eliminate the occurrence of gastroesophageal reflux episodes, which cause regurgitation and respiratory symptoms. Selected group of patients with pulmonary disease and proven GERD may benefit from antireflux surgery.