Published: 04-04-2018 14:18 | Updated: 04-04-2018 14:19

New thesis on clinical and oncopreventive aspects of antireflux surgery

John Maret-Ouda from the research group Upper GI Surgery will defend his thesis "Clinical and oncopreventive aspects of antireflux surgery" on April 6, 2018. Main Supervisor is professor Jesper Lagergren.

John Maret Ouda

What's the main focus of your thesis?

My thesis highlights different aspects of antireflux surgery, which is surgery against heartburn and acidic reflux. Heartburn is very common and it is estimated to affect 10 to 20% of the adult population to the extent that it decreases quality of life. Heartburn can either be treated medically, which is most common, or surgically. The two first articles in the thesis concerns clinical outcomes following antireflux surgery, among these outcomes are risks associated to surgery, trends regarding the use of surgery in Sweden and the risk of recurrence of reflux that requires treatment following the antireflux surgery. The two later articles examines the possible prevention of oesophageal cancer following surgery, since this cancer is strongly associated to reflux symptoms and it is also a cancer that has become drastically more common during the last decades.

Which are the most important results?

We’ve been able to show that antireflux surgery is a very safe operation with good long-term outcomes regarding the risk of recurrence of reflux. We’ve also been able to show that the risk of developing oesophageal cancer drastically decreases over time following surgery. After more than 15 years, the risk among the operated patients is the same as among the general background population, which are very exciting results.

How can this new knowledge contribute to the improvement of people's health?

One of the conclusions is that antireflux surgery is an effective but potentially underused treatment option in clinical praxis. We can also see that the number of surgeries performed in Sweden drastically decreased since the turn of the millennium. This decrease is partly due to the frequent use of the highly effective medications that are available on the market. However, among young and otherwise healthy individuals with low surgical risk who might need to take medication during a very long period of time, with the potential side effects associated to this, surgery should be considered. It is also among these groups that we’ve found the lowest risk of recurrence of reflux symptoms after surgery.

What are your future ambitions?

In the future I would like to conduct research in close connection to my clinical position. I believe research complements the clinical work in a very appealing way and leads you to think in new ways at the same time as the clinical work awakens new research questions. This creates a synergy that both helps the patients and develops the research. I also hope to do research with international research colleagues through future research projects at a university abroad.


Friday April 6, 2018 at 10:00, Atrium, Wargentinhuset, Nobels väg 12 B. KI Campus Solna


Clinical and oncopreventive outcomes of antireflux surgery