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J Gastric Cancer. 2018 Dec;18(4):313-327. doi: 10.5230/jgc.2018.18.e41. Epub 2018 Dec 27.

Evidence-Based Practice Guideline for Surgical Treatment of Gastroesophageal Reflux Disease 2018.

Seo HS1,2, Choi M3, Son SY1,4, Kim MG1,5, Han DS1,6, Lee HH1,2.

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Guideline Committee of Korean Anti-Reflux Surgery (KARS) Study Group.
Division of Gastrointestinal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Division of Health Technology Assessment Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Korea.
Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Department of Surgery, Hanyang University Guri Hospital, Hanyang University School of Medicine, Seoul, Korea.
Department of Surgery, Seoul National University Boramae Hospital, Seoul, Korea.


The prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea, and physicians, including surgeons, have been focusing on its treatment. Indeed, in Korea, medical treatment using a proton pump inhibitor is the mainstream treatment for GERD, while awareness of surgical treatment is limited. Accordingly, to promote the understanding of surgical treatment for GERD, the Korean Anti-Reflux Surgery Study Group published the Evidence-Based Practice Guideline for the Surgical Treatment of GERD. The guideline consists of 2 sections: fundamental information such as the definition, symptoms, and diagnostic tools of GERD and a recommendation statement about its surgical treatment. The recommendations presented 5 debates regarding fundoplication: 1) comparison of the effectiveness of medical and surgical treatments, 2) effectiveness of surgical treatment in cases of refractory GERD, 3) effectiveness of surgical treatment of extraesophageal symptoms, 4) comparison of effectiveness between total and partial fundoplication, and 5) effectiveness of fundoplication in cases of hiatal hernia. The present guideline is the first to demonstrate the efficacy of the surgical treatment GERD in Korea.


Fundoplication; Gastroesophageal reflux; Guideline; Systematic review; Treatment

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Conflict of Interest: No potential conflict of interest relevant to this article was reported.

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