A Prospective Multicenter Registry of Patients with Chronic Gastroesophageal Reflux Disease Receiving Transoral Incisionless Fundoplication

Bell, Reginald; Mavrelis, Peter G.; Barnes, William E.; Dargis, David; Carter, Bart J.; Hoddinott, Kevin M.; Sewell, Robert W.; Trad, Karim S.; Gill, Brian D.; Ihde, Glenn

doi:10.1016/j.jamcollsurg.2012.07.014

Cited by 67 publications

(58 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Six months after TIF, GERD symptoms had improved according to the reduction in GERD-HRQL scores (from 26 [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35]) to 10 [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], P < 0.01). Common use of acid suppressive medication was discontinued by 67% of patients, whereas 19% used PPIs occasionally and common use was present in 14%.…”

Section: Patient Characteristics and Symptom Scoresmentioning

confidence: 99%

“…5 However, in uncontrolled trials normalization of acid exposure time is only present in 37-50% of patients with a lack of correlation between objective and subjective treatment outcomes assessed with pH-metry and validated questionnaires. [6][7][8] Previous studies have attempted to identify patient characteristics and objective parameters like lower esophageal sphincter (LES) resting pressure and the number of fasteners that may help to predict treatment outcome of the TIF procedure. 9,10 However, up to now, no objective parameter is available to select patients for this endoluminal procedure.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Does Measurement of Esophagogastric Junction Distensibility by EndoFLIP Predict Therapy- responsiveness to Endoluminal Fundoplication in Patients With Gastroesophageal Reflux Disease?

Smeets

Keszthelyi

Bouvy

et al. 2015

J Neurogastroenterol Motil

View full text Add to dashboard Cite

Background/Aims In patients with gastroesophageal reflux disease (GERD), an increased esophagogastric junction (EGJ) distensibility has been described. Assessment of EGJ distensibility with the endoscopic functional luminal imaging probe (EndoFLIP) technique might identify patients responsive to transoral incisionless fundoplication (TIF), whereas postoperative measurement of EGJ distensibility might provide insight into the antireflux mechanism of TIF. Therefore, we investigated the value of the EndoFLIP technique in GERD patients treated by TIF. Methods Forty-two GERD patients underwent EGJ distensibility measurement before TIF using the EndoFLIP technique. In a subgroup of 25 patients, EndoFLIP measurement was repeated both postoperative and at 6 months follow-up. Treatment outcome was assessed according to esophageal acid exposure time (AET; objective outcome) and symptom scores (clinical outcome) 6 months after TIF. Results Multiple logistic regression analysis showed that preoperative EGJ distensibility (OR, 0.16; 95% CI, 0.03–0.78; P = 0.023) and preoperative AET (OR, 0.62; 95% CI, 0.42–0.90; P = 0.013) were independent predictors for objective treatment outcome but not for clinical outcome after TIF. The best cut-off value for objective outcome was 2.3 mm 2 /mmHg for preoperative EGJ distensibility and 11% for preoperative AET. EGJ distensibility decreased direct postoperative from 2.0 (1.2–3.3) to 1.4 (1.0–2.2) mm 2 /mmHg ( P = 0.014), but increased to 2.2 (1.5–3.0) at 6 months follow-up ( P = 0.925, compared to preoperative). Conclusions Preoperative EGJ distensibility and preoperative AET were independent predictors for objective treatment outcome but not for clinical outcome after TIF. According to our data, the EndoFLIP technique has no added value either in the preoperative diagnostic work-up or in the post-procedure evaluation of endoluminal antireflux therapy.

show abstract

Section: Patient Characteristics and Symptom Scoresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does Measurement of Esophagogastric Junction Distensibility by EndoFLIP Predict Therapy- responsiveness to Endoluminal Fundoplication in Patients With Gastroesophageal Reflux Disease?

Smeets

Keszthelyi

Bouvy

et al. 2015

J Neurogastroenterol Motil

View full text Add to dashboard Cite

show abstract

“…Less-invasive endoscopic suturing devices as the Endocinch (Bard Endoscopic Technologies, Nurray Hill, NJ, USA), Plicator (NDO Surgical Inc., Mansfield, MA, USA) and the EsophyX (EndoGastric Solutions, Inc., Silver Spring, MD, USA) have tried to mimic the effects of conventional anti-reflux surgery by the creation of gastroesophageal plications. [29][30][31] Although early improvements in symptoms and medication use were reported in several trials, clinical efficacy or durability to the level of conventional anti-reflux surgery have not been met. 32 The Enteryx procedure aimed to increase sphincter competence by injection of sponge-like material into the LES.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, 18 patients have completed 3-month follow-up and 14 patients 6-month follow-up. Interim results showed a positive ef- fect on symptoms: GERD-HRQL median (IQR) score was 4 (2-11) at 3 months and 5 (4-9) at 6 months, respectively with P < 0.001 and P < 0.01 when compared to baseline score off PPI (31 [25][26][27][28][29][30][31][32][33][34][35][36][37]). Furthermore, acid exposure time decreased from 11.3% (9.0-15.5%) at baseline to 3.3% (2.5-9.1%) at 3 months and to 2.6% (1.8-5.4%) at 6 months (Fig.…”

mentioning

confidence: 99%

Electrical Stimulation Therapy for Gastroesophageal Reflux Disease

Rinsma

Bouvy

Masclee

et al. 2014

J Neurogastroenterol Motil

View full text Add to dashboard Cite

Electrical stimulation therapy (EST) of the lower esophageal sphincter is a relatively new technique for the treatment of gastroesophageal reflux disease (GERD) that may address the need of GERD patients, unsatisfied with acid suppressive medication and concerned with the potential risks of surgical fundoplication. In this paper we review available data about EST for GERD, including the development of the technique, implant procedure, safety and results from open-label trials. Two short-term temporary stimulation and long-term open-label human trials each were initiated to investigate the safety and efficacy of EST for the treatment of GERD and currently up to 2 years follow-up results are available. The results of EST are promising as the open-label studies have shown that EST is a safe technique with a significant improvement in both subjective outcomes of symptoms and objective outcomes of esophageal acid exposure in patients with GERD. However, long-term data from larger number of patients and a sham-controlled trial are required before EST can be conclusively advised as a viable treatment option for GERD patients.

show abstract

“…Bell et al in a study of 100 consecutive patients found that GERD Health-Related Quality of Life (GERD-HRQL) total score was normalized in 73 %, and major adverse events occurred [14]. A randomized controlled trial of TIF versus PPI was presented at the Digestive Disease Week conference this year.…”

Section: Trans-oral Incisionless Fundoplication (Tif)mentioning

confidence: 99%

Gastroesophageal Reflux Disease: Diagnosis and Patient Selection

Singhal

Khaitan

2014

Indian J Surg

View full text Add to dashboard Cite

Gastroesophageal reflux disease (GERD) has a high prevalence worldwide. Recent reports have noted a high prevalence even in Asian countries. GERD significantly affects the quality of life and can present with a wide variety of symptoms. Not all reflux is acid, and non-acid reflux disease can be more difficult to diagnose and can lead to a variety of extra-esophageal symptoms. Although proton pump inhibitors (PPIs) are effective in the majority of patients, but they are not without side effects, and their effect often diminishes with time. For patients who do not desire to be on long-term PPIs or have incomplete symptom resolution with medication, various endoscopic and minimally invasive treatment modalities are now available. The etiology of GERD can be multifactorial including dysfunctional LES, presence of a hiatal hernia, and transient lower esophageal sphincter relaxations (TLESRs). We hence believe that the treatment should be individualized to the cause of the reflux. In the following review, we describe the etiology of reflux disease and attempt to lay a framework for the diagnosis and selection of patients for the various interventions available for treatment, along with their evidence base.

show abstract

A Prospective Multicenter Registry of Patients with Chronic Gastroesophageal Reflux Disease Receiving Transoral Incisionless Fundoplication

Cited by 67 publications

References 31 publications

Does Measurement of Esophagogastric Junction Distensibility by EndoFLIP Predict Therapy- responsiveness to Endoluminal Fundoplication in Patients With Gastroesophageal Reflux Disease?

Does Measurement of Esophagogastric Junction Distensibility by EndoFLIP Predict Therapy- responsiveness to Endoluminal Fundoplication in Patients With Gastroesophageal Reflux Disease?

Electrical Stimulation Therapy for Gastroesophageal Reflux Disease

Gastroesophageal Reflux Disease: Diagnosis and Patient Selection

Contact Info

Product

Resources

About