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| 1 | Comparison of Stretta procedure and toupet fundoplication for gastroesophageal reflux disease-related extra-esophageal symptoms显示文摘AIM: To compare the outcomes between the Stretta procedure and laparoscopic toupet fundoplication(LTF) in patients with gastroesophageal reflux disease(GERD)-related extra-esophageal symptoms.METHODS: From January 2011 to February 2012, a total of 98 patients diagnosed with GERD-related extra-esophageal symptoms who met the inclusion criteria were enrolled in this study. All patients who either underwent the Stretta procedure or LTF treatment have now completed the 3-year follow-up. Primary outcome measures, including frequency and severity of extra-esophageal symptoms, proton pump inhibitor(PPI) use, satisfaction, and postoperative complications, were assessed. The results of the Stretta procedure and LTF therapy were analyzed and compared.RESULTS: There were 47 patients in the Stretta group and 51 patients in the LTF group. Ninety patients were available at the 3-year follow-up. The total of the frequency and severity scores for every symptom improved in both groups(P < 0.05). Improvementin symptom scores of cough, sputum, and wheezing did not achieve statistical significance between the two groups(P > 0.05). However, the score for globus hysterics was different between the Stretta group and the LTF group(4.9 ± 2.24 vs 3.2 ± 2.63, P < 0.05). After the Stretta procedure and LTF treatment, 29 and 33 patients in each group achieved PPI therapy independence(61.7% vs 64.7%, P = 0.835). The patients in the LTF group were more satisfied with their quality of life than those in the Stretta procedure group(P < 0.05). Most complications resolved without intervention within two weeks; however, two patients in the LTF group still suffered from severe dysphagia 2 wk after the operation, and it improved after bougie dilation treatment in both patients.CONCLUSION: The Stretta procedure and LTF were both safe and effective for the control of GERD-related extra-esophageal symptoms and the reduction of PPI use. | Chao Yan Wei-Tao Liang Zhong-Gao Wang Zhi-Wei Hu Ji-Min Wu Chao Zhang Mei-Ping Chen | 2015 | World Journal of Gastroenterology2015，21，45： | 17 |
| 2 | Update on novel endoscopic therapies to treat gastroesophageal reflux disease: A review显示文摘Endoscopic treatments for gastroesophageal reflux disease(GERD) have become increasingly popular in recent years. While surgical intervention with the Laparoscopic Nissen Fundoplication remains the gold standard, two endoscopic interventions, specifically, are gaining traction in clinical use(Esophy X and Stretta). The Esophy X(Endo Gastric Solutions, Inc., Redmond, WA, United States) was developed as a method of restoring the valve at the GE junction through an endoluminal fundoplication(ELF) technique. Long-term data suggests that transoral incisional fundoplication(TIF) with Esophy X may be effective for symptom control and proton pump inhibitor reduction or cessation for up to 2-6 years. There is no evidence that Esophy X is more effective than surgical intervention. TIF may be most effective for patients with HH < 2 cm and Hill Grade I/II valves. Stretta(Mederi Therapeutics, Greenwich, CT, United States) was approved by the Food and Drug Administration in 2000. It delivers radiofrequency energy to the lower esophageal sphincter and gastric cardia. Published reviews of the literature are conflicted in their recommendations of Stretta in the management of GERD. The literature suggests that the Stretta procedure has an acceptable safety profile and may be effective in reducing symptom burden and quality of life scores up to 8 years post-intervention. However, there does not appear to be any sustained improvement in objective outcomes and there is no evidence that Stretta results in improved outcomes as compared to surgical intervention. Treatment modalities for GERD, as a field, suffer from a lack of standardization in primary and secondary outcomes. Although many studies have looked at health related quality of life, the tools used to do so are markedly heterogeneous. Future directions for the endoscopic treatment of GERD include novel techniques like endoscopic submucosal dissection. | Jessica Hopkins Noah J Switzer Shahzeer Karmali | 2015 | World Journal of Gastrointestinal Endoscopy2015，7，11： | 2 |
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