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Long-term benefit of transoral incisionless fundoplication using the esophyx device for the management of gastroesophageal reflux disease responsive to medical therapy.
Dis Esophagus 2017; 30(3):1-8DE

Abstract

Transoral incisionless fundoplication (TIF) using the EsophyX device has been shown to be effective and safe in patients with Gastroesophageal reflux disease (GERD); however, the subset of patients that would mostly benefit from this technique remains unknown. The aim of this study was to evaluate the long-term efficacy and safety of the TIF procedure in patients with a history of esophagitis or proven chronic GERD who have achieved symptom control with the administration of proton pump inhibitors (PPIs) but did not wish to continue receiving medications for life. Forty-five patients with typical GERD symptoms (heartburn, regurgitation, chest pain) and a history of esophagitis grade A and B or proven GERD by esophageal pH monitoring underwent TIF using Esophyx. Patients with eosphagitis C and D or those with large hiatal hernias (>2 cm in length) were excluded. The primary clinical effectiveness measure was GERD symptom elimination at follow up based on normalization of the GERD health related quality of life (GERD-HRQL) questionnaire. After a median follow up period of 59 months (36-75) the median GERD-HRQL scores improved significantly from 27 (2-45) at baseline to 4 (0-26) (P < 0.001) in the 44 patients completing the study. Heartburn was eliminated in 12 out of the 21 patients included (57.1%), regurgitation was eliminated in 15 out of the 17 patients included (88.2%) and finally chest pain was eliminated in 5 patients out of the six patients included (83.3%). Overall, 32 patients out of the 44 patients (72.7%) that completed the study follow up reported elimination of their main symptom, without the need for PPI administration (none PPI usage). Furthermore, six more patients (13.6%), five with heartburn, and one with regurgitation reported half PPI dose taken for <50% of the preceding follow up period (occasional PPI usage), while six more patients (four with heartburn, one with regurgitation, and one with chest pain) reported full or half PPI dose taken for more than 50% of the preceding follow up period (daily PPI usage). Creation of an esophagogastric fundoplication using the EsophyX device abolished reflux symptoms in 72.7% of PPI-responsive GERD patients at a median 59 month follow-up.

Authors+Show Affiliations

Gastroenterology Department, Athens Naval Hospital, Athens, Greece.Gastroenterology Department, Evangelismos Hospital, Athens, Greece.Gastroenterology Department, Athens Naval Hospital, Athens, Greece.Gastroenterology Department, Athens Naval Hospital, Athens, Greece.Gastroenterology Department, Athens Naval Hospital, Athens, Greece.Anesthesiology Department, Athens Naval Hospital, Athens, Greece.Anesthesiology Department, Athens Naval Hospital, Athens, Greece.2nd Academic Department of Internal Medicine, Hippokration Hospital of Athens, Athens, Greece.

Pub Type(s)

Evaluation Studies
Journal Article
Multicenter Study

Language

eng

PubMed ID

27868281

Citation

Stefanidis, Gerasimos, et al. "Long-term Benefit of Transoral Incisionless Fundoplication Using the Esophyx Device for the Management of Gastroesophageal Reflux Disease Responsive to Medical Therapy." Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus, vol. 30, no. 3, 2017, pp. 1-8.
Stefanidis G, Viazis N, Kotsikoros N, et al. Long-term benefit of transoral incisionless fundoplication using the esophyx device for the management of gastroesophageal reflux disease responsive to medical therapy. Dis Esophagus. 2017;30(3):1-8.
Stefanidis, G., Viazis, N., Kotsikoros, N., Tsoukalas, N., Lala, E., Theocharis, L., ... Manolakopoulos, S. (2017). Long-term benefit of transoral incisionless fundoplication using the esophyx device for the management of gastroesophageal reflux disease responsive to medical therapy. Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus, 30(3), pp. 1-8. doi:10.1111/dote.12525.
Stefanidis G, et al. Long-term Benefit of Transoral Incisionless Fundoplication Using the Esophyx Device for the Management of Gastroesophageal Reflux Disease Responsive to Medical Therapy. Dis Esophagus. 2017 Feb 1;30(3):1-8. PubMed PMID: 27868281.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term benefit of transoral incisionless fundoplication using the esophyx device for the management of gastroesophageal reflux disease responsive to medical therapy. AU - Stefanidis,Gerasimos, AU - Viazis,Nikos, AU - Kotsikoros,Nikolaos, AU - Tsoukalas,Nikolaos, AU - Lala,Eythymia, AU - Theocharis,Loukas, AU - Fassaris,Andreas, AU - Manolakopoulos,Spilios, PY - 2016/11/22/pubmed PY - 2017/10/25/medline PY - 2016/11/22/entrez KW - fundoplication KW - gastroesophageal reflux KW - proton pump inhibitors KW - transoral incisionless SP - 1 EP - 8 JF - Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus JO - Dis. Esophagus VL - 30 IS - 3 N2 - Transoral incisionless fundoplication (TIF) using the EsophyX device has been shown to be effective and safe in patients with Gastroesophageal reflux disease (GERD); however, the subset of patients that would mostly benefit from this technique remains unknown. The aim of this study was to evaluate the long-term efficacy and safety of the TIF procedure in patients with a history of esophagitis or proven chronic GERD who have achieved symptom control with the administration of proton pump inhibitors (PPIs) but did not wish to continue receiving medications for life. Forty-five patients with typical GERD symptoms (heartburn, regurgitation, chest pain) and a history of esophagitis grade A and B or proven GERD by esophageal pH monitoring underwent TIF using Esophyx. Patients with eosphagitis C and D or those with large hiatal hernias (>2 cm in length) were excluded. The primary clinical effectiveness measure was GERD symptom elimination at follow up based on normalization of the GERD health related quality of life (GERD-HRQL) questionnaire. After a median follow up period of 59 months (36-75) the median GERD-HRQL scores improved significantly from 27 (2-45) at baseline to 4 (0-26) (P < 0.001) in the 44 patients completing the study. Heartburn was eliminated in 12 out of the 21 patients included (57.1%), regurgitation was eliminated in 15 out of the 17 patients included (88.2%) and finally chest pain was eliminated in 5 patients out of the six patients included (83.3%). Overall, 32 patients out of the 44 patients (72.7%) that completed the study follow up reported elimination of their main symptom, without the need for PPI administration (none PPI usage). Furthermore, six more patients (13.6%), five with heartburn, and one with regurgitation reported half PPI dose taken for <50% of the preceding follow up period (occasional PPI usage), while six more patients (four with heartburn, one with regurgitation, and one with chest pain) reported full or half PPI dose taken for more than 50% of the preceding follow up period (daily PPI usage). Creation of an esophagogastric fundoplication using the EsophyX device abolished reflux symptoms in 72.7% of PPI-responsive GERD patients at a median 59 month follow-up. SN - 1442-2050 UR - https://www.unboundmedicine.com/medline/citation/27868281/Long_term_benefit_of_transoral_incisionless_fundoplication_using_the_esophyx_device_for_the_management_of_gastroesophageal_reflux_disease_responsive_to_medical_therapy_ L2 - https://academic.oup.com/dote/article-lookup/doi/10.1111/dote.12525 DB - PRIME DP - Unbound Medicine ER -