Long-term outcomes of patients with refractory gastroesophageal reflux disease following a minimally invasive endoscopic procedure: a prospective observational study

BMC Gastroenterology

Research Article

Guang-Chang Zhu¹  Zhi-Wei Hu¹  Feng Wang¹  Jian-Jun Liu¹  Yue Yang¹  Ji-Min Wu¹  Chao Zhang¹  Wei-Tao Liang²  Zhong-Gao Wang² 

[1] Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of the Chinese People’s Liberation Army, 16 Xinwai Street, Xicheng District, 100088, Beijing, China;Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of the Chinese People’s Liberation Army, 16 Xinwai Street, Xicheng District, 100088, Beijing, China;Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University, Beijing, China;

关键词: Gastroesophageal reflux disease (GERD);    Stretta procedure;    Radiofrequency delivery;    Long-term outcomes;   

DOI  :  10.1186/1471-230X-14-178

 received in 2014-02-04, accepted in 2014-09-29,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundGastroesophageal reflux disease (GERD) is the most common digestive disease, affecting one third of the world’s population. The minimally invasive endoscopic Stretta procedure is being increasingly used as an alternative strategy to manage refractory GERD. However, long-term benefits of this procedure have to be further evaluated in clinical settings. This prospective observational study was therefore conducted to evaluate the outcome of patients with refractory GERD 5 years after the Stretta procedure.MethodsA total of 152 patients with refractory GERD underwent the Stretta procedure in our department between April 2007 and September 2008. They were followed up for 5 years, during which the primary outcome measures including symptom scores of heartburn, regurgitation, chest pain, cough and asthma and the secondary outcome measures including proton pump inhibitor (PPI) use and patients’ satisfaction were analysed at 6, 12, 24, 36, 48 and 60 months respectively.ResultsOf the 152 patients, 138 completed the designated 5-year follow-up and were included in the final analysis. At the end of the 5-year follow-up, the symptom scores of heartburn (2.47 ± 1.22 vs. 5.86 ± 1.52), regurgitation (2.23 ± 1.30 vs. 5.56 ± 1.65), chest pain (2.31 ± 0.76 vs. 4.79 ± 1.59), cough (3.14 ± 1.43 vs. 6.62 ± 1.73) and asthma (3.26 ± 1.53 vs. 6.83 ± 1.46) were all significantly decreased as compared with the corresponding values before the procedure (P < 0.001). After the Stretta procedure, 59 (42.8%) patients achieved complete PPI therapy independence and 104 (75.4%) patients were completely or partially satisfied with the GERD symptom control. Moreover, no severe complications were observed except for complaint of abdominal distention in 12 (8.7%) patients after the Stretta procedure.ConclusionThe Stretta procedure may achieve an effective and satisfactory long-term symptom control and considerably reduce the reliance on medication without significant adverse effects in adult patients with refractory GERD, thereby having profound clinical implications.

【 授权许可】

Unknown   
© Liang et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.