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Open Access 01-11-2012 | Endoluminal Surgery

Transoral incisionless fundoplication for treatment of gastroesophageal reflux disease in clinical practice

Authors: Bart P. L. Witteman, Rob Strijkers, Eva de Vries, Liza Toemen, José M. Conchillo, Wim Hameeteman, Pieter C. Dagnelie, Ger H. Koek, Nicole D. Bouvy

Published in: Surgical Endoscopy | Issue 11/2012

Abstract

Background

Transoral incisionless fundoplication is a recently introduced endoluminal technique for the treatment of gastroesophageal reflux disease (GERD). The objective of this study was to determine outcomes in chronic GERD patients who were referred for surgical management.

Methods

A cohort of 38 patients underwent transoral incisionless fundoplication (TIF) in a tertiary care setting. Pre- and post-procedure assessment included GERD-related quality of life questionnaires, proton pump inhibitor (PPI) usage, 24-h pH measurements, upper gastrointestinal endoscopy, esophageal manometry, and registration of adverse events. Duration of follow-up was 36 months.

Results

Gastroesophageal valves were constructed of 4 cm (range, 4–6) in length and 220° (range, 180–240) in circumference. One serious adverse event occurred, consisting of intraluminal bleeding at a fastener site. Hiatal hernia was completely reduced in 56 % and esophagitis was cured in 47 % of patients. Postprocedure esophageal acid exposure did not significantly improve (p > 0.05). At 36 (range, 29–41) months follow-up 14 patients (36 %) had undergone revisional laparoscopic fundoplication. Quality of life scores of the remaining cohort showed significant improvement (p < 0.0001) and daily use of antisecretory medication was discontinued by 74 %.

Conclusions

Endoluminal fundoplication improved quality of life and reduced the need for PPIs in only a subgroup of patients at 3 years follow-up. The amount of patients requiring additional medication and revisional surgery was high.

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Title: Transoral incisionless fundoplication for treatment of gastroesophageal reflux disease in clinical practice
Authors: Bart P. L. Witteman
Rob Strijkers
Eva de Vries
Liza Toemen
José M. Conchillo
Wim Hameeteman
Pieter C. Dagnelie
Ger H. Koek
Nicole D. Bouvy
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 11/2012
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-012-2324-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Transoral incisionless fundoplication for treatment of gastroesophageal reflux disease in clinical practice

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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