156. Anti-Reflux Radiofrequency Therapy Using Stretta for Refractory Gord Is Feasible and Reduces the Need for Minimally Invasive Surgery

Abstract

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.