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Russian Journal of Gastroenterology, Hepatology, Coloproctology

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Russian Consensus: Standardization of Indications for Surgical Treatment of GERD

https://doi.org/10.22416/1382-4376-2025-35-1-74-93

Abstract

Aim: to present the results of an Expert Consensus on standardization of indications for surgical treatment of gastroesophageal reflux disease (GERD).
Materials and methods. The issues of standardization of indications for surgical treatment of GERD were discussed by 39 experts – leading gastroenterologists and surgeons from 7 cities of Russia, representing 17 institutions. The list of questions for discussion was formed by the initiative group and sent to the experts. The experts reviewed recent literature, including existing clinical guidelines and consensuses, assessed the evidence base and suggested statements for voting based on the analysis of relevant provisions of foreign consensuses, high-level scientific publications, which set out information obtained in the course of studies that meet the criteria of evidence-based medicine, positions on this issue in the Russian Federation, and suggested statements for voting. Delphi method was used to reach the consensus.
Results. GERD is the most common benign esophageal disorder. Surgery is considered one of the treatment methods for GERD. In real clinical practice, selection of patients who may benefit from surgery is challenging. The results of surgical and conservative treatment of GERD are comparable. Surgical treatment should be performed in a specialized hospital only after a joint examination with a gastroenterologist confirming the diagnosis of GERD. An appropriate volume of preoperative diagnostic workup, matters related to surgical interventions in case of incomplete response to proton pump inhibitors (PPIs) and when extraesophageal manifestations of GERD are present were discussed. The consensus reviews the indications, contraindications and possible results of antireflux operations in patients with GERD. The value of endoscopy, esophageal manometry, pH monitoring/pH-impedance monitoring and X-ray polypositional examination of the upper gastrointestinal tract as a preoperative examination of the patient is analysed.
Conclusions. The experts reached the consensus on 20 statements on standardization of indications for surgical treatment of GERD.

About the Authors

I. Ye. Khatkov
Loginov Moscow Clinical Scientific Center; Russian University of Medicine
Russian Federation

Igor Ye. Khatkov — Dr. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Director; Head of the Department of Intermediate Level Surgery 

111123, Moscow, Novogireyevskaya str., 1, build. 1.


D. S. Bordin
Loginov Moscow Clinical Scientific Center; Russian University of  Medicine; Tver State Medical University
Russian Federation

Dmitry S. Bordin — Dr. Sci. (Med.), Head of the Department of Pathology of the Pancreas, Bile Tract and Upper Digestive Tract; Professor of the Department of Propaedeutics of  Internal Medicine and  Gastroenterology; Professor of the Department of General Medical Practice and  Family Medicine, Faculty of Postgraduate Education 

111123, Moscow, Novogireyevskaya str., 1, build. 1.


O. S. Vasnev
Loginov Moscow Clinical Scientific Center
Russian Federation

Oleg S. Vasnev — Dr. Sci. (Med.), Head of the Department of High-Tech Surgery and Surgical Endoscopy 

111123, Moscow, Novogireyevskaya str., 1, build. 1.


S. R. Abdulkhakov
Kazan (Volga Region) Federal University; Kazan State Medical University
Russian Federation

Sayar R. Abdulkhakov — Cand. Sci. (Med.), Head of the Department of Internal Medicine, Institute of Fundamental Medicine and Biology; Associate Professor of the Department of Outpatient Therapy and General Medical Practice 

420012, Kazan, Kremlevskaya str., 18.


A. S. Allakhverdyan
Russian University of Medicine
Russian Federation

Aleksandr S. Allakhverdyan — Dr. Sci. (Med.), Professor, Head of the Department of Thoracic Surgery 

127473, Moscow, Delegatskaya str., 20, build. 1.


D. N. Andreev
Russian University of Medicine
Russian Federation

Dmitry N. Andreev — Cand. Sci. (Med.), Associate Professor of the Department of Propaedeutics of Internal Medicine and  Gastroenterology 

127473, Moscow, Delegatskaya str., 20, build. 1.


V. V. Anishchenko
Novosibirsk State Medical University
Russian Federation

Vladimir V. Anishchenko — Dr. Sci. (Med.), Professor, Head of the Department of Surgery, Faculty of Advanced Training and Professional Retraining 

630099, Novosibirsk, Kommunisticheskaya str., 17/1.


I. G. Bakulin
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Igor G. Bakulin — Dr. Sci. (Med.), Professor, Head of  the Department of Propaedeutics of Internal Medicine, Gastroenterology and Dietetics named after S.M. Ryss 

191015, Saint Petersburg, Kirochnaya str., 41.


N. V. Bakulina
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Natalia V. Bakulina — Dr. Sci. (Med.), Head of the Department of Internal Medicine, Nephrology, General and Clinical Pharmacology with a Course in Pharmacy 

191015, Saint Petersburg, Kirochnaya str., 41.


M. V. Burmistrov
Kazan (Volga Region) Federal University
Russian Federation

Mikhail V. Burmistrov — Dr. Sci. (Med.), Head of the Department of Surgical Diseases of Postgraduate Education; Deputy Chief Medical Officer, Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan. 

420064, Kazan, Orenurgsky tract, 138.


E. R. Valitova
Loginov Moscow Clinical Scientific Center
Russian Federation

Elen R. Valitova — Cand. Sci. (Med.), Head of the Laboratory of Functional Diagnostics of Esophagus and Stomach Diseases 

111123, Moscow, Novogireyevskaya str., 1, build. 1.


D. I. Vasilevsky
Academician I.P. Pavlov First Saint Petersburg State Medical University
Russian Federation

Dmitry I. Vasilevsky — Dr. Sci. (Med.), Professor, Head of the Department of Surgical Diseases of the Faculty of Dentistry named after Prof. A.M. Ganichkin 

197022, Saint Petersburg, L’va Tolstogo str., 6-8.


F. P. Vetshev
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Fedor P. Vetshev — Dr. Sci. (Med.), Head of the Department of Intermediate Level Surgery No. 1 

119435, Moscow, Pogodinskaya str., 1, build. 1.


E. A. Gallyamov
Russian University of Medicine
Russian Federation

Eduard A. Gallyamov — Dr. Sci. (Med.), Professor of the Department of Intermediate Level Surgery No. 1 

127473, Moscow, Delegatskaya str., 20, build. 1.


S. A. Domrachev
Russian University of Medicine
Russian Federation

Sergey A. Domrachev — Dr. Sci. (Med.), Professor, Professor of the Department of Intermediate Level Surgery No. 2 

127473, Moscow, Delegatskaya str., 20, build. 1.


R. Ye. Izrailov
Loginov Moscow Clinical Scientific Center
Russian Federation

Roman Ye. Izrailov — Dr. Sci. (Med.), Head of the Department of Innovative Surgery 

111123, Moscow, Novogireyevskaya str., 1, build. 1.


V. A. Isakov
Federal Research Center of Nutrition, Biotechnology and Food Safety
Russian Federation

Vasily A. Isakov — Dr. Sci. (Med.), Professor, Head of the Department of Gastroenterology, Hepatology and Diet Therapy 

109240, Moscow, Ustyinsky lane, 2/14.


V. O. Kaybysheva
N.I. Pirogov Russian National Research Medical University
Russian Federation

Valeria O. Kaybysheva — Cand. Sci. (Med.), Senior Researcher, Research Laboratory of Surgical Gastroenterology and Endoscopy 

117513, Moscow, Ostrovityanova str., 1.


M. A. Koshkin
Loginov Moscow Clinical Scientific Center
Russian Federation

Mikhail A. Koshkin — Cand. Sci. (Med.), Head of Short-Stay Inpatient Department 

111123, Moscow, Novogireyevskaya str., 1, build. 1.


Yu. A. Kucheryavyy
Ilyinskaya Hospital
Russian Federation

Yury A. Kucheryavyy — Cand. Sci. (Med.), Head of the Gastroenterology Department 

143421, Moscow Region, Krasnogorsk Okrug, Glukhovo village, Rublevskoe Predmestie str., 2, build 2.


M. A. Livzan
Omsk State Medical University
Russian Federation

Maria A. Livzan — Dr. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Intermediate Level Therapy and Gastroenterology, Rector 

644099, Omsk, Lenina str., 12.


O. E. Lutsevich
Russian University of Medicine
Russian Federation

Oleg E. Lutsevich — Dr. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Intermediate Level Surgery No. 1 

127473, Moscow, Delegatskaya str., 20, build. 1.


I. V. Maev
Russian University of Medicine
Russian Federation

Igor V. Maev — Dr. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Head of the Department of Propaedeutics of Internal Medicine and Gastroenterology 

127473, Moscow, Delegatskaya str., 20, build. 1.


S. V. Morozov
Federal Research Center of Nutrition, Biotechnology and Food Safety; Russian Medical Academy of Continuous Professional Education
Russian Federation

Sergey V. Morozov — Dr. Sci. (Med.), Leading Researcher of the Department of Gastroenterology, Hepatology and  Diet Therapy; Professor of the Department of Gastroenterology 

109240, Moscow, Ustyinsky lane, 2/14.


A. A. Moroshek
Kazan (Volga Region) Federal University
Russian Federation

Anton A. Moroshek—Dr.Sci. (Med.),SeniorLecturer of the Department of Surgical Diseases of Postgraduate Education 

420008, Kazan, Kremlevskaya str., 18.


M. F. Osipenko
Novosibirsk State Medical University
Russian Federation

Marina F. Osipenko — Dr. Sci. (Med.), Professor, Head of the Department of Propaedeutics of Internal Diseases 

630091, Novosibirsk, Krasny Avenue, 52.


M. V. Pavlov
Loginov Moscow Clinical Scientific Center
Russian Federation

Mikhail V. Pavlov — Radiologist 

111123, Moscow, Novogireyevskaya str. 1, build. 1.


E. V. Parfenchikova
Loginov Moscow Clinical Scientific Center
Russian Federation

Elena V. Parfenchikova — Dr. Sci. (Med.), Head of the Department of Diagnostic Endoscopy 

111123, Moscow, Novogireyevskaya str. 1, build. 1.


D. V. Ruchkin
National Medical Research Center of Surgery named after A. Vishnevsky
Russian Federation

Dmitry V. Ruchkin — Dr. Sci. (Med.), Head of the Department of Reconstructive Surgery of the Esophagus and  Stomach 

117997, Moscow, Bolshaya Serpukhovskaya str., 27.


A. V. Sazhin
N.I. Pirogov Russian National Research Medical University
Russian Federation

Alexander V. Sazhin — Dr. Sci. (Med.), Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Department of Intermediate Level Surgery No. 1 

117513, Moscow, Ostrovityanova str., 1.


A. A. Smirnov
Academician I.P. Pavlov First Saint Petersburg State Medical University
Russian Federation

Alexander A. Smirnov — Dr. Sci. (Med.), Head of the Endoscopy Department, Research Institute of Surgery and  Emergency Medicine, Associate Professor of the Department of Hospital Surgery No. 2 

197022, Saint Petersburg, L’va Tolstogo str., 6-8.


O. A. Storonova
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Olga A. Storonova — Cand. Sci. (Med.), Physician of the Functional Diagnostics Department, V. Kh. Vasilenko Clinic of  Propaedeutics of Internal Medicine, Gastroenterology and Hepatology 

119435, Moscow, Pogodinskaya str., 1, build. 1.


A. S. Trukhmanov
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Alexander S. Trukhmanov — Dr. Sci. (Med.), Professor of the Department of Propaedeutics of Internal Medicine, Gastroenterology and Hepatology of the N.V. Sklifosovsky Institute of Clinical Medicine 

119435, Moscow, Pogodinskaya str., 1, build. 1.


T. V. Khorobrykh
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Tatiana V. Khorobrykh — Dr. Sci. (Med.), Professor, Professor of the Russian Academy of Sciences, Head of the Department of Intermediate Level Surgery No. 2 named after G.I. Lukomsky of the N.V. Sklifosovsky Institute of Clinical Medicine 

119435, Moscow, Pogodinskaya str., 1, build. 1.


M. F. Cherkasov
Rostov State Medical University
Russian Federation

Mikhail F. Cherkasov —Dr. Sci. (Med.), Professor, Head of Department of Surgery No. 4 

344022, Rostov-on-Don, Nakhichevansky Lane, 29.


A. L. Shestakov
Petrovsky National Research Centre of Surgery
Russian Federation

Aleksey L. Shestakov — Dr. Sci. (Med.), Head of the Department of Esophagus and Stomach Surgery 

119435, Moscow, Abrikosovsky lane, 2.


K. V. Shishin
Loginov Moscow Clinical Scientific Center
Russian Federation

Kirill V. Shishin — Dr. Sci. (Med.), Head of Endoscopy Department 

111123, Moscow, Novogireyevskaya str., 1, build. 1.


Yu. V. Embutnieks
Loginov Moscow Clinical Scientific Center
Russian Federation

Yulia V. Embutnieks — Dr. Sci. (Med.), Head of the Department of Upper Gastrointestinal Tract Pathology 

111123, Moscow, Novogireyevskaya str., 1, build. 1.


V. T. Ivashkin
I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Vladimir T. Ivashkin — Dr. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Head of the Department of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology of the N.V. Sklifosovsky Institute of Clinical Medicine 

119435, Moscow, Pogodinskaya str., 1, build. 1.


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Review

For citations:

Khatkov I.Ye., Bordin D.S., Vasnev O.S., Abdulkhakov S.R., Allakhverdyan A.S., Andreev D.N., Anishchenko V.V., Bakulin I.G., Bakulina N.V., Burmistrov M.V., Valitova E.R., Vasilevsky D.I., Vetshev F.P., Gallyamov E.A., Domrachev S.A., Izrailov R.Ye., Isakov V.A., Kaybysheva V.O., Koshkin M.A., Kucheryavyy Yu.A., Livzan M.A., Lutsevich O.E., Maev I.V., Morozov S.V., Moroshek A.A., Osipenko M.F., Pavlov M.V., Parfenchikova E.V., Ruchkin D.V., Sazhin A.V., Smirnov A.A., Storonova O.A., Trukhmanov A.S., Khorobrykh T.V., Cherkasov M.F., Shestakov A.L., Shishin K.V., Embutnieks Yu.V., Ivashkin V.T. Russian Consensus: Standardization of Indications for Surgical Treatment of GERD. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2025;35(1):74-93. https://doi.org/10.22416/1382-4376-2025-35-1-74-93

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Tatiana L. Lapina - MD, PhD, associate professor, Department of Internal Diseases Propedeutics,
I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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