Radiofrequency (RF) therapy of the lower oesophageal sphincter using STRETTA strengthens the reflux barrier across the gastro-oesophageal junction. Numerous studies have shown improvement in reflux symptoms, reduction in proton pump inhibitor (PPI) dependence and need for surgical treatment for gastro-oesophageal reflux disease (GORD). We present the largest series from Europe, and aim to assess long term outcomes of STRETTA for patients with medically refractory GORD. Data for all patients who underwent STRETTA from October 2014 till April 2021 were prospectively maintained on a database and was analysed retrospectively. Patients and primary care doctor practices were contacted to obtain information on PPI free period (PFP) after STRETTA therapy, which was defined as the time between STRETTA and recommencement of prescribed and daily consumption of PPI medication. As required medication use was not considered for PFP calculation. Statistical analysis and graphical presentation were carried out using Minitab® and GraphPad Prism®. Mann–Whitney test was used to compare two sets of non-parametric data and a p < 0.05 was considered significant. From 195 patients (median age 55, 116 females (59%)) who underwent STRETTA, PFP data were available for 144 (74%) patients. Sixty-six patients (45%) remained without PPI after a median follow-up of 4.5 years (52 months). Six patients (3%) went on to have a further intervention. There was a significant negative correlation between PFP and age (p = 0.023) with no differences between the genders (p = 0.90). Patients <55 years had a longer PFP than >55 years (p = 0.012). Younger males had a significantly longer PFP than older males (0.03). However, this was not observed in the female cohort (p = 0.14). Our findings suggest STRETTA as a safe and feasible option for treating medically refractory GORD, especially in younger patients. STRETTA does reduce the need for long term PPI and lessens the frequency of further interventions such as surgery. Further studies are required to investigate the mechanisms by which STRETTA is beneficial in the younger patient.

Background Medical workers, including surgical professionals working in COVID-19 treating hospitals, were under enormous stress during the pandemic. This global study investigated factors endowing COVID amongst surgical professionals and students. Methods This global cross-sectional survey was made live on the 18th of February, 2021, and closed for analysis on the 13th of March, 2021. It was freely shared on social and scientific media platforms. It was also sent via email groups and circulated through a personal network of authors. Chi-square test for independence, binary logistic regression analysis was carried on determining predictors of surgical professionals contracting COVID-19. Results This survey captured the response of 520 respondents from 66 countries. 92.29% (503/545) were working in a hospital receiving patients with COVID-19. More than one-fourth (25.5%) caught COVID-19, which was more frequent in participants working in public sector hospitals (P=0.001). 75.7% of those who did not contract Covid (283/376) were vaccinated (P<0.001). Surgical professionals undergoing practice in the private sector (OR: 0.33; 95% CI: 0.14–0.77; p=0.011) and getting two doses of vaccines (OR: 0.55; 95% CI: 0.32–0.95; p=0.031) had decreased odds of contracting COVID-19. Only 6.9% of those who reported not contracting COVID-19 (26/376) were calculated to have the highest Level of Harm score (LH4) (P<0.001). Conclusions High prevalence of respondents caught COVID-19, which was more frequent in participants working in public sector hospitals. Self-isolation or shield, getting two doses of vaccines decreases the odds of contracting COVID-19. Those who reported contracting COVID-19 were calculated to have the highest Level of Harm score.

Introduction The STRETTA© system of using radiofrequency (RF) energy to the gastro-oesophageal junction (GOJ) for management of refractory gastro-oesophageal reflux disease (GORD) has shown to improve baseline symptoms, PPI dependence and reduce the need for anti-reflux operations in select group of patients. We aimed to review our outcomes of STRETTA© for patients with medically refractory GORD. Methods A retrospective review of a prospectively maintained database was carried out in a tertiary British centre. All patients who underwent STRETTA© procedure from 2015 were reviewed. General practises and individual patients were followed up to obtain the proton pump inhibitor (PPI) free time after undergoing STRETTA© procedure. Results A total of 200 patients underwent STRETTA© procedure from 2015. All patients were reviewed once in clinic between 4–6 weeks with an overall median follow-up of 34.5 months. Preliminary analysis suggest over half of the patients (54%, n=108) remaining without PPI usage. Data for median time before restarting proton pump inhibitors (PPI) after STRETTA© is being collected. No patients needed further STRETTA© treatment and 2 patients (1%) has gone onto have anti-reflux procedure for non-resolution of symptoms. Conclusion Our preliminary findings suggest STRETTA© as a valuable and feasible option for treating refractory GERD. It may help reduce the need for fundoplication procedures and our data suggests that it increases the time before which surgery is required.

Background/Aims: Radiofrequency treatment of the gastroesophageal junction using the Stretta procedure for treating gastroesophageal reflux disease (GERD) is observed to improve the symptoms and proton pump inhibitor (PPI) dependence and reduce the need for anti-reflux operations. As one of the largest studies in Europe, we evaluated the clinical outcomes of Stretta in patients with medically refractory GERD.Methods: A tertiary UK center evaluated all patients with refractory GERD who underwent Stretta between 2014 and 2022. Patients and primary care professionals were contacted to obtain information regarding the initiation of PPI and reintervention after Stretta.Results: Of the 195 patients (median age, 55 years; 116 women [59.5%]) who underwent Stretta, PPI-free period (PFP) data were available for 144 (73.8%) patients. Overall, 66 patients (45.8%) did not receive PPI after a median follow-up of 55 months. Six patients (3.1%) underwent further interventions. The median PFP after Stretta was 41 months. There was a significant negative correlation between PFP and age (p=0.007), with no differences between sexes (p=0.96). Patients younger than 55 years of age had a longer PFP than their older counterparts (p=0.005). Younger males had a significantly longer PFP than older males (p=0.021). However, this was not observed in the female cohort (p=0.09) or between the younger men and women (p=0.66).Conclusions: Our findings suggest that Stretta is a safe and feasible option for treating refractory GERD, especially in younger patients. It prevents further anti-reflux interventions in most patients and increases the lead-time to surgery in patients with refractory GERD.