TY - JOUR T1 - Surgery relieved symptoms but decreased survival more than medical treatment in gastro-oesophageal reflux disease JF - Evidence Based Medicine JO - Evid Based Med SP - 26 LP - 26 DO - 10.1136/ebm.7.1.26 VL - 7 IS - 1 A2 - , Y1 - 2002/01/01 UR - http://ebm.bmj.com/content/7/1/26.abstract N2 - Spechler SJ, Lee E, Ahnen D, et al. Long-term outcome of medical and surgical therapies for gastroesophageal reflux disease. Follow-up of a randomized controlled trial.JAMA2001 May 9;285:2331–8.OpenUrlCrossRefPubMedWeb of Science
 
 QUESTION: In patients with complicated gastro-oesophageal reflux disease (GORD), how do the long term outcomes of surgical treatment compare with those of medical treatments? Randomised (allocation concealed*), blinded (unclear),* controlled trial with a mean follow up of 10 years. 8 Veterans Affairs medical centres in the US. 247 patients (mean age 58 y) with complicated GORD. 129 of 160 surviving patients (mean age 67 y, 98% men) were included in the follow up analysis. Patients were allocated to receive surgical treatment (n=82), continuous medical treatment (n=77), or symptomatic medical treatment (n=88). The method of surgical treatment was open Nissen fundoplication. Continuous medical treatment consisted of 2 antacid tablets, 1 and 3 hours after meals; ranitidine 150 mg twice daily; and metoclopramide 10 mg 4 times daily, and sucralfate 1 g … ER -