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Laparoscopic surgery was more effective than medical management for GORD disease
Evidence-Based Medicine, 06/10/09

Grant A - 62% of patients in the surgical group and 6% in the medical group received surgery. At 12 months, 38% and 90%, respectively, were taking reflux-related drugs. The table shows the questionnaire results. At 1 year, the mean per-patient cost of treatment was £1786 in the surgical group and £506 in the medical group (difference £1280, 95% CI 1054 to 1468). Surgical treatment achieved an increase of 0.066 (CI 0.026 to 0.107) QALYs compared with medical treatment. The incremental cost-effectiveness ratio was £19 288/QALY.In patients with chronic gastro-oesophageal reflux disease, a strategy of early laparoscopic surgery improved quality of life and reduced symptoms more than continued medical management at least up to 1 year after surgery; however, the cost-effectiveness of surgical treatment at 1 year is uncertain.

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