Keywords
Surgical procedures operative
Proton pump inhibitors
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Abstract
Objective: To identify the main factors for surgical indication in patients with gastroesophageal reflux disease. Methods: This is an integrative review, consisting of six methodological steps. For the literature search, the inclusion criteria were original articles in Portuguese, English, and Spanish from 2020 to 2025 in the Medline and Lilacs databases, and the health descriptors were: gastroesophageal reflux; surgical procedures; and proton pump inhibitors. Using the search strategy, 49 articles were found. After reading the titles, abstracts, and full texts, nine articles were selected for critical analysis, according to the PRISMA flowchart. Results: The main factors for surgical indication were presented in a table: patients with incomplete or unsatisfactory response, contraindications, or intolerable side effects to PPIs; patient desire to discontinue medication use; persistence and worsening of symptoms; complicated esophageal and extraesophageal GERD; and hiatal hernia. Final considerations: The clinical decision to end medical treatment and proceed with surgery should be based on the goal of stopping symptoms, improving quality of life, and preventing GERD complications in patients.
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