Endoscopic day case antireflux radiofrequency (Stretta) therapy improves quality of life and reduce proton pump inhibitor (PPI) dependency in patients with gastro-oesophageal reflux disease: a prospective study from a UK tertiary centre

Abstract

BackgroundEndoscopic antireflux radiofrequency treatment (Stretta) offers a therapeutic alternative for patients suffering from refractory gastro-oesophageal reflux disease (GORD). Current evidence suggests that the treatment may improve symptoms of GORD and decrease requirement for proton pump inhibitor (PPI) therapy.MethodsProspective assessment of patients undergoing Stretta, between October 2014 and February 2016, in a UK tertiary referral centre was carried. All patients were assessed for suitability using endoscopy, contrast studies, and pH and manometry studies. The Gastro-oesophageal Reflux Disease-Health-Related Quality of Life (GERD-HRQL) was used to evaluate symptoms along with PPI dependency, pre-Stretta and post-Stretta treatment. Patients were followed up by outpatient clinic appointment and telephone consultation.ResultsFifty consecutive patients were followed up for a median of 771 days (range 499–1162) following treatment with Stretta. The average GERD-HRQL score improved from 46.2/75 (±14.2) preprocedure to 15.2/75 (±17.3) postprocedure. Dissatisfaction with GORD as measured in the GERD-HRQL decreased from 100% to 10% with three patients showing no improvement (non-responders) at follow up and two late failures at the time of this review. There were no complications and all cases were carried out as day cases.ConclusionThere are currently few effective therapeutic alternatives to antireflux surgery for refractory GORD. This series corroborates the value and safety of Stretta as a viable option for selected patients who are unwilling or unable to undergo an operation. Stretta improves quality of life and decreases PPI dependency in selected patients with GORD.

Minimal Invasive Surgery for Gastroesophageal Reflux Disease and Hiatus Hernia—Our Experience: A Case Series with Review of Literature

“…Nissen's fundoplication is performed to treat GERD and HH. 7,8 GERD is a common illness that impacts large numbers of the population in the modern era. A minority of patients Minimal Invasive Surgery for GERD and HH Harvitkar, Joshi with GERD have a constantly weak low pressure LES (less than 6 mm Hg), which allows reflux every time the pressure in the stomach exceeds LES pressure.…”

“…Nissen's fundoplication is performed to treat GERD and HH. 7,8 GERD is a common illness that impacts large numbers of the population in the modern era. A minority of patients The diagnosis of GERD is typically made by corelating symptoms and objective test results.…”

The Outcome of Endoscopic Radiofrequency Anti-Reflux Therapy (STRETTA) for Gastroesophageal Reflux Disease in Patients with Previous Gastric Surgery: A Prospective Cohort Study

“…The indications for STRETTA in our center are in conformity with the NICE guideline according to which, if proton pump inhibitor (PPI) medication has failed to resolve the symptoms, endoscopic radiofrequency therapy may be used before or after the surgery. 3…”

Gastroesophageal reflux disease: recent innovations in endoscopic assessment and treatment

“…Two multicenter, prospective, and observational studies assessed 55 and 138 patients undergoing the Stretta procedure, respectively. The first study showed that the average GERD-Health Related Quality of Life (GERD-HRQL) score decreased to 15.2 post-operatively from 46.2 preoperatively after 771-day follow-up [ 42 ]. The second study with a 5-year follow-up evaluated the improvement in GERD-associated symptoms and found that the severity of heartburn, thoracalgia, and asthma was obviously relieved after the Stretta procedure, and 42.8% of patients completely ceased to take PPIs.…”