A narrative review of minimally invasive fundoplication for gastroesophageal reflux disease and interstitial lung disease

Abstract

Interstitial lung disease (ILD) encompasses a heterogeneous group of acute and chronic disorders characterized by diffuse pulmonary infiltrates with histologic features of pulmonary inflammation, dyspnea, and restrictive lung patterns. Gastroesophageal reflux disease (GERD) and ILD are two pathological conditions often strictly related, even if a clear relationship of causality has not been demonstrated. The mechanisms leading to ILD are not completely understood, although it is recognized that different factors are involved. In recent years, it has been suggested that acid gastroesophageal reflux is an important cause of both systemic sclerosis (SSc)-ILD and idiopathic pulmonary fibrosis (IPF). It has been hypothesized that micro aspiration of gastric material may play a fundamental role in the fibrotic transformation of pulmonary parenchyma. According to that, some studies have described antireflux procedures for patients affected by ILD and GERD. However, although some studies reported good results in terms of improvement of lung function, the role of antireflux surgery remains uncertain as well as not univocal. An extensive literature search was performed from January 1970 to 31 December 2020 in PubMed and the Cochrane Central Register of Controlled Trials. The research was limited to English-language studies. The aim of the present study was to summarize the effect of antireflux surgery for the treatment of abnormal acid GER on the natural history of this disease.