• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on Web of Science (3)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Revascularization  • Cardiovascular System  • Surgery  • Surgical Interventions  • Endoscopy/ Minimally Invasive Surgery  • Gastrointestinal/ Upper Foregut  • Vascular Surgery  • Prognosis/ Outcomes  • Gastroenterology  • Gastrointestinal Diseases  • Cardiovascular Intervention  • Alert me on articles by topic  Social Bookmarking   What's this?

An Outcomes Comparison

Louis O. Jeansonne IV, MD; Brent C. White, MD; Vien Nguyen, MD; Syed M. Jafri, BS; Vickie Swafford, RN; Mina Katchooi, DDS; Leena Khaitan, MD, PhD; S. Scott Davis, MD; C. Daniel Smith, MD; Shahriar Sedghi, MD; Edward Lin, DO

Arch Surg. 2009;144(1):19-24.

Hypothesis  Endoluminal therapies have emerged as adjuncts for the treatment of gastroesophageal reflux disease (GERD) in select patients.

Objective  To compare the effectiveness of endoscopic full-thickness plication and endoscopic radiofrequency treatments for patients with GERD.

Patients  A total of 126 patients who underwent either endoscopic full-thickness plication (FTP) of the gastric cardia or endoscopic radiofrequency (RF) treatment of the esophagogastric junction during a 4-year period were included (68 underwent RF and 58 underwent FTP).

Interventions  Follow-up data was obtained for 51% of patients (mean follow-up, 6 months).

Main Outcome Measures  Comparison of medication use, symptom scores, and pH values at baseline and follow-up.

Results  In the RF group, patients with moderate to severe heartburn decreased from 55% to 22% (P < .01), and proton pump inhibitor (PPI) use decreased from 84% to 50% (P = .01). Decreases were also seen for dysphagia, voice symptoms, and cough. Percentage of time the pH was less than 4 was unchanged. In the FTP group, patients with moderate to severe heartburn decreased from 53% to 43% (P = .3), and PPI use decreased from 95% to 43% (P = .01). Percentage of time the pH was less than 4 decreased from 10.0% to 6.1% (P = .05). Decreases were also seen for regurgitation, voice symptoms, and dysphagia. There was no change in scores for chest pain or asthma in either group.

Conclusions  For patients with GERD, RF and FTP both resulted in a decrease in both PPI use and in scores for voice symptoms and dysphagia. In addition, RF resulted in decreased heartburn and cough, while FTP resulted in the most dramatic reduction in regurgitation. Our experience indicates that both procedures are effective, providing symptomatic relief and reduction in PPI use. For patients whose chief complaint is regurgitation, FTP may be the preferred procedure.

Author Affiliations: Emory Endosurgery Unit, Emory University School of Medicine, Atlanta, Georgia (Drs Jeansonne, White, Jafri, Khaitan, Davis, Smith, and Lin and Ms Swafford), and the Medical Center of Central Georgia, Macon (Drs Nguyen, Katchooi, and Sedghi).

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Endoluminal Full-Thickness Plication and Radiofrequency Treatments for GERD—Invited Critique
Jon Gould
Arch Surg. 2009;144(1):24.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Gastroesophageal Reflux Disease
ANDERSON
radtech 2010;81:251-268.
ABSTRACT | FULL TEXT