Skip to main content
Top
Published in: Surgical Endoscopy 8/2016

Open Access 01-08-2016

Long-term follow-up results of endoscopic treatment of gastroesophageal reflux disease with the MUSE™ endoscopic stapling device

Authors: Hong Joo Kim, Chang-Il Kwon, William R. Kessler, Don J. Selzer, Gail McNulty, Amol Bapaye, Luigi Bonavina, Glen A. Lehman

Published in: Surgical Endoscopy | Issue 8/2016

Login to get access

Abstract

Background

The initial 6-month data for MUSE™ (Medigus, Omer, Israel) endoscopic stapling device were reported (Zacherl et al. in Surg Endosc 29:220–229, 2015). The current study aims to evaluate the long-term clinical outcome of 37 patients who received endoscopic gastroesophageal reflux disease (GERD) treatment with the MUSE™ device.

Methods

Efficacy and safety data for 37 patients were analyzed at baseline, 6 months, and 4 years post-procedure. In one center (IU), efficacy and safety data were evaluated at baseline, 6 months post-procedure, and then annually up to 4 years.

Results

No new complications have been reported in our long-term analysis. The proportions of patients who remained off daily PPI were 83.8 % (31/37) at 6 months and 69.4 % (25/36) at 4 years post-procedure. GERD-Health Related Quality of Life (HRQL) scores (off PPI) were significantly decreased from baseline to 6 months and 4 years post-procedure. The daily dosage of GERD medications, measured as omeprazole equivalents (mean ± SD, mg), decreased from 66.1 ± 33.2 at baseline to 10.8 ± 15.9 at 6 months and 12.8 ± 19.4 at 4 years post-procedure (P < 0.01).

Conclusions

In our multi-center prospective study, the MUSE™ stapling device appears to be safe and effective in improving symptom scores as well as reducing PPI use in patients with GERD. These results appeared to be equal to or better than those of the other devices for endoluminal GERD therapy. Future studies with larger patient series, sham control group, and greater number of staples are awaited.
Literature
1.
go back to reference Chiba N, De Gara CJ, Wilkinson JM et al (1997) Speed of healing and symptom relief in grade II to IV gastroesophageal reflux disease: a meta-analysis. Gastroenterology 112:1798–1810CrossRefPubMed Chiba N, De Gara CJ, Wilkinson JM et al (1997) Speed of healing and symptom relief in grade II to IV gastroesophageal reflux disease: a meta-analysis. Gastroenterology 112:1798–1810CrossRefPubMed
2.
go back to reference Donnellan C, Sharma N, Preston C et al (2010) Medical treatments for the maintenance therapy of reflux oesophagitis and endoscopic negative reflux disease. Cochrane Database Syst Rev (2):CD003245. doi:10.1002/14651858.CD003245.pub2 Donnellan C, Sharma N, Preston C et al (2010) Medical treatments for the maintenance therapy of reflux oesophagitis and endoscopic negative reflux disease. Cochrane Database Syst Rev (2):CD003245. doi:10.​1002/​14651858.​CD003245.​pub2
3.
go back to reference Lundell L, Miettinen P, Myrold HE et al (2001) Continued (5-year) follow-up of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease. J Am Coll Surg 192:172–181CrossRefPubMed Lundell L, Miettinen P, Myrold HE et al (2001) Continued (5-year) follow-up of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease. J Am Coll Surg 192:172–181CrossRefPubMed
4.
go back to reference DeVault KR, Castell DO, American College of Gastroenterology (2005) Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol 100:190–200CrossRefPubMed DeVault KR, Castell DO, American College of Gastroenterology (2005) Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol 100:190–200CrossRefPubMed
5.
go back to reference Malfertheiner P, Lind T, Willich S et al (2005) Prognostic influence of Barrett’s oesophagus and Helicobacter pylori infection on healing of erosive gastro-oesophageal reflux disease (GORD) and symptom resolution in non-erosive GORD: report from the ProGORD study. Gut 54:746–751CrossRefPubMedPubMedCentral Malfertheiner P, Lind T, Willich S et al (2005) Prognostic influence of Barrett’s oesophagus and Helicobacter pylori infection on healing of erosive gastro-oesophageal reflux disease (GORD) and symptom resolution in non-erosive GORD: report from the ProGORD study. Gut 54:746–751CrossRefPubMedPubMedCentral
6.
go back to reference Jones R, Armstrong D, Malfertheiner P, Ducrotte P (2006) Does the treatment of gastroesophageal reflux disease (GERD) meet patients’ needs? A survey-based study. Curr Med Res Opin 22:657–662CrossRefPubMed Jones R, Armstrong D, Malfertheiner P, Ducrotte P (2006) Does the treatment of gastroesophageal reflux disease (GERD) meet patients’ needs? A survey-based study. Curr Med Res Opin 22:657–662CrossRefPubMed
7.
go back to reference Clayton SB, Rife CC, Singh ER, Kalbfleisch JH, Castel DO (2012) Twice-daily proton pump inhibitor therapy does not decrease the frequency of reflux episodes during nocturnal recumbency in patients with refractory GERD: analysis of 200 patients using multichannel intraluminal impedence pH testing. Dis Esophagus 25:682–686CrossRefPubMed Clayton SB, Rife CC, Singh ER, Kalbfleisch JH, Castel DO (2012) Twice-daily proton pump inhibitor therapy does not decrease the frequency of reflux episodes during nocturnal recumbency in patients with refractory GERD: analysis of 200 patients using multichannel intraluminal impedence pH testing. Dis Esophagus 25:682–686CrossRefPubMed
8.
go back to reference Milkes D, Gerson LB, Triadafilopoulos G (2004) Complete elimination of reflux symptoms does not guarantee normalization of intraesophageal and intragastric pH in patients with gastroesophageal reflux disease (GERD). Am J Gastroenterol 99:991–996CrossRefPubMed Milkes D, Gerson LB, Triadafilopoulos G (2004) Complete elimination of reflux symptoms does not guarantee normalization of intraesophageal and intragastric pH in patients with gastroesophageal reflux disease (GERD). Am J Gastroenterol 99:991–996CrossRefPubMed
9.
go back to reference Crawley JA, Schmitt CM (2000) How satisfied are chronic heartburn sufferers with their prescription medications? Results of the patient unmet needs survey. Clin Outcomes Manag 7:29–34 Crawley JA, Schmitt CM (2000) How satisfied are chronic heartburn sufferers with their prescription medications? Results of the patient unmet needs survey. Clin Outcomes Manag 7:29–34
10.
go back to reference Gallup Organization (2000) The 2000 gallup study of consumers’ use of stomach relief products. Gallup Organization, Princeton Gallup Organization (2000) The 2000 gallup study of consumers’ use of stomach relief products. Gallup Organization, Princeton
11.
go back to reference Rothstein RI (2008) Endoscopic therapy of gastroesophageal reflux disease: outcomes of the randomized-controlled trials done to date. J Clin Gastroenterol 42:594–602CrossRefPubMed Rothstein RI (2008) Endoscopic therapy of gastroesophageal reflux disease: outcomes of the randomized-controlled trials done to date. J Clin Gastroenterol 42:594–602CrossRefPubMed
12.
go back to reference Chen D, Barber C, McLoughlin P, Thavaneswaran P, Jamieson GG, Maddern GJ (2009) Systematic review of endoscopic treatments for gastro-oesophageal reflux disease. Br J Surg 96:128–136CrossRefPubMed Chen D, Barber C, McLoughlin P, Thavaneswaran P, Jamieson GG, Maddern GJ (2009) Systematic review of endoscopic treatments for gastro-oesophageal reflux disease. Br J Surg 96:128–136CrossRefPubMed
13.
go back to reference Zacherl J, Roy-Shapira A, Bonavina L et al (2015) Endoscopic anterior fundoplication with the Medigus Ultrasonic Surgical Endostapler (MUSE™) for gastroesophageal reflux disease: 6-month results from a multi-center prospective trial. Surg Endosc 29:220–229CrossRefPubMed Zacherl J, Roy-Shapira A, Bonavina L et al (2015) Endoscopic anterior fundoplication with the Medigus Ultrasonic Surgical Endostapler (MUSE™) for gastroesophageal reflux disease: 6-month results from a multi-center prospective trial. Surg Endosc 29:220–229CrossRefPubMed
14.
go back to reference Pleskow D, Rothstein R, Kozarek R, Haber G, Gostout C, Lembo A (2007) Endoscopic full-thickness plication for the treatment of GERD: long-term multicenter results. Surg Endosc 21:439–444CrossRefPubMed Pleskow D, Rothstein R, Kozarek R, Haber G, Gostout C, Lembo A (2007) Endoscopic full-thickness plication for the treatment of GERD: long-term multicenter results. Surg Endosc 21:439–444CrossRefPubMed
15.
go back to reference Testoni PA, Vailati C, Testoni S, Corsetti M (2012) Transoral incisionless fundoplication (TIF 2.0) with EsophyX for gastroesophageal reflux disease: long-term results and findings affecting outcome. Surg Endosc 26:1425–1435CrossRefPubMed Testoni PA, Vailati C, Testoni S, Corsetti M (2012) Transoral incisionless fundoplication (TIF 2.0) with EsophyX for gastroesophageal reflux disease: long-term results and findings affecting outcome. Surg Endosc 26:1425–1435CrossRefPubMed
16.
go back to reference Noar M, Squires P, Noar E, Lee M (2014) Long-term maintenance effect of radiofrequency energy delivery for refractory GERD: a decade later. Surg Endosc 28:2323–2333CrossRefPubMed Noar M, Squires P, Noar E, Lee M (2014) Long-term maintenance effect of radiofrequency energy delivery for refractory GERD: a decade later. Surg Endosc 28:2323–2333CrossRefPubMed
17.
go back to reference DeVault KR, Hinder RA, Floch N (2005) Endoscopic treatment of reflux: a quest for the holy grail of reflux? J Clin Gastroentrol 39:178–180CrossRef DeVault KR, Hinder RA, Floch N (2005) Endoscopic treatment of reflux: a quest for the holy grail of reflux? J Clin Gastroentrol 39:178–180CrossRef
18.
go back to reference Hogan WJ (2006) Clinical trials evaluating endoscopic GERD treatments: is it time for a moratorium on the clinical use of these procedures? Am J Gastroentrol 101:437–439CrossRef Hogan WJ (2006) Clinical trials evaluating endoscopic GERD treatments: is it time for a moratorium on the clinical use of these procedures? Am J Gastroentrol 101:437–439CrossRef
Metadata
Title
Long-term follow-up results of endoscopic treatment of gastroesophageal reflux disease with the MUSE™ endoscopic stapling device
Authors
Hong Joo Kim
Chang-Il Kwon
William R. Kessler
Don J. Selzer
Gail McNulty
Amol Bapaye
Luigi Bonavina
Glen A. Lehman
Publication date
01-08-2016
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 8/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4622-y

Other articles of this Issue 8/2016

Surgical Endoscopy 8/2016 Go to the issue