摘要胃食管反流病是一种致病机制复杂、临床表现多样、严重影响患者身心健康的常见消化道疾病，根据胃镜下食管黏膜有无破损分为非糜烂性反流病及反流性食管炎。目前胃食管反流病尤其是非糜烂性反流病及轻度反流性食管炎多采用以质子泵抑制剂为主的内科治疗，但质子泵抑制剂不能改变此病的病理生理学机制或减少反流次数。药物疗效欠佳且合并结构性改变时，腹腔镜胃底折叠术是有效治疗方法，在主观症状、客观检查、生活质量、患者满意度等方面均优于内科治疗，但尚未得到足够重视。常用的3种抗反流手术方式的优劣尚有争议，需根据患者临床分型、发病机制、年龄、精神状态及食管运动功能选择最佳术式。胃食管反流病是一种慢性疾病，内、外科治疗均有一定风险，选择治疗方案时需充分考虑患者的意愿。

abstractsGastroesophageal reflux disease (GERD) is a common digestive disease with characteristics of a multitude of pathogenesis, a variety of clinical manifestations and a strong negative impact on physical and mental health of the patients. GERD is classified into non-erosive reflux disease and reflux esophagitis in terms of absence or presence of mucosal damage at endoscopic findings. Proton pump inhibitors (PPI) are widely used in the treatment of GERD, especially for patients with non-erosive reflux disease or mild reflux esophagitis. However, PPI do not affect pathophysiologic mechanisms of GERD or reduce the number of reflux events. When PPI fails to adequately control the symptoms of GERD as a result of gastroesophagel junction structural defects, the antireflux surgical procedures are indicated to create a mechanical barrier to reflux. The laparoscopic fundoplication remains the most commonly performed and is the current "gold-standard" anti-reflux procedure. The outcomes of the antireflux surgical procedures are superior to medical therapy for GERD in light of subjective symptoms, objective examinations, quality of life and patient satisfaction. As of now, enough attention has not been paid to the traditional surgical procedures of GERD in China. It is controversial about which is optimal among the three major types of procedures, selection should be tailored to classification, mechanism, age, mental status and esophageal motility. GERD is a chronic disease and either medical or surgical therapy may put the patient at different risk, therefore the patient′s preferences should be considered adequately before choosing the treatment protocols.