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Laparoscopic fundoplication relieves symptoms of gastroesophageal reflux disease (GERD). However, whether fundoplication provides long-term relief is unclear. In this study, investigators in the U.K. randomized 360 patients with GERD who had been treated for >12 months with proton-pump inhibitors (PPIs) to either laparoscopic fundoplication or optimal medical management; follow-up was 5 years. Patients who declined to participate because of strong preferences for either surgery or medical management were followed in two nonrandomized arms of the trial. One-year outcomes were reported previously (JW Gen Med Jan 27 2009).
At 5 years, 63% of patients randomized to surgery and 13% of those randomized to medical management had undergone fundoplic…