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October 10, 2001

Medical vs Surgical Treatment of Gastroesophageal Reflux

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;286(14):1709-1712. doi:10.1001/jama.286.14.1709

To the Editor: Dr Spechler and colleagues1 found that 62% of patients who underwent surgical therapy for gastroesophageal reflux disease (GERD) later required antisecretory therapy. However, their study design limits the conclusions on treatment efficacy because they did not follow their patients longitudinally over the entire follow-up period, but only assessed them at 1 point 10 to 13 years after the surgery or the initial medical treatment period. Patient outcomes during the decade preceding the time of the study are not known. This is a problem, particularly in assessing efficacy as measured by symptom and medication questionnaires, endoscopy, and pH monitoring.