Short-term safety and symptomatic outcomes of transoral incisionless fundoplication with or without hiatal hernia repair in patients with chronic gastroesophageal reflux disease

Long-term efficacy of transoral incisionless fundoplication with Esophyx (Tif 2.0) and factors affecting outcomes in GERD patients followed for up to 6 years: a prospective single-center study

“…The manometric and pH-impedance findings confirm our previous data [13], but in a larger series: the numbers of total and acid refluxes, measured by impedance monitoring, were significantly lower, while the LES basal pressure, DEA, and Johnson-DeMeester score did not change significantly. Discordance between the relief of overall symptoms and conflicting motility test findings has also been reported in studies of the outcomes of TIF and other endoscopic procedures for GER [13,31].…”

“…Discordance between the relief of overall symptoms and conflicting motility test findings has also been reported in studies of the outcomes of TIF and other endoscopic procedures for GER [13,31]. This suggests that with the present technique, it is probably more the greater length of the newly created valve (more accurately measurable by endoscopy rather than by standard manometry) than its pressure that acts as a barrier to reflux; this mechanism may also explain the sustained response over time, despite the worsening of the Hill's grade of the valve in some patients.…”

“…At the end of the procedure, Hill's grade and Jobe length of the newly created valve and the number of fasteners deployed were recorded. Post-procedural management was described in our previous papers [9,13].…”

“…The procedure was designed to create serosa-toserosa plications which include the muscle layers and construct valves 3-5 cm long, taking in 200-300°of the circumference, deploying multiple non-absorbable polypropylene fasteners through the two layers (esophagus and stomach) in a circumferential pattern around the gastroesophageal junction [4][5][6]. Previous studies reported the persistence of the newly created valve at 6 months and for up to 36 years, with good functional outcomes, judging from 24-h pH-and/or impedance monitoring [7][8][9][10][11][12][13][14][15][16][17][18]. However, like all new procedures introduced in clinical practice, despite favorable short-term outcomes, questions still arise about the long-term efficacy of the technique in controlling symptoms, and the duration of the newly created valve.…”

New Minimally Invasive Endoscopic and Surgical Therapies for Gastroesophageal Reflux Disease (GERD)

“…Complications occurred in 2.4% of cases (bleeding and perforations), while longtime follow-up showed a reduction in efficacy over time (40). In the case of GERD recurrence after TIF, the procedure may be repeated or LF can be performed, and in the case of recurrence after NLF an EF may be performed with EsophyX or, in those with HH ≥ 2 cm, through hybrid intervention, initially laparoscopic for HH cure, and then TIF (41)(42)(43).…”