PMID- 17321232
OWN - NLM
STAT- MEDLINE
DCOM- 20070405
LR  - 20151119
IS  - 0016-5107 (Print)
IS  - 0016-5107 (Linking)
VI  - 65
IP  - 3
DP  - 2007 Mar
TI  - Sustained improvement in symptoms of GERD and antisecretory drug use: 4-year 
      follow-up of the Stretta procedure.
PG  - 367-72
AB  - BACKGROUND: Approximately 20% of patients with GERD do not respond to medical 
      therapy. The Stretta radiofrequency antireflux procedure represents an 
      alternative to failed drug therapy for GERD. OBJECTIVE: The aim of this study was 
      to assess symptom and medication changes after the Stretta procedure during a 
      4-year follow-up period. DESIGN: Prospective case series on intent-to-treat 
      basis. SETTING: Community practice. PATIENTS: Patients with GERD with persistent 
      symptoms despite twice-daily proton pump inhibitor (PPI) medications. 
      INTERVENTIONS: The Stretta procedure was performed in drug-refractory patients 
      with GERD diagnosed by the presence of endoscopically evidenced esophagitis or 
      abnormal esophageal pH testing. Symptom assessment was performed with a validated 
      health-related quality-of-life questionnaire (with and without medication) at 
      baseline and 6, 12, 24, 36, and 48 months after treatment. Complications of the 
      procedure and medication usage were analyzed. MAIN OUTCOME MEASUREMENTS: 
      Significant changes in symptom scores, GERD quality-of-life parameters, and 
      medication usage on the basis of clinical outcomes. RESULTS: We report on a 
      series of 109 consecutive patients treated with the Stretta procedure who have 
      reached 4-year follow-up. Complete long-term follow-up assessment was available 
      in matched data for 109 patients at 12 months, 108 patients at 24 months, 102 
      patients at 36 months, and 96 patients at 48 months. A second procedure was 
      performed in 13 patients. Heartburn scores decreased from 3.6 to 1.18 (P < .001), 
      total heartburn score (GERD health-related quality-of-life questionnaire) 
      decreased from 27.8 to 7.1 (P < .001), and patient satisfaction improved from 1.4 
      to 3.8 (P < .001) (see ). Medication usage decreased significantly from 100% of 
      patients on twice-daily PPI therapy at baseline to 75% of patients showing 
      elimination of medications or only as-needed use of antacids/over-the-counter 
      PPIs at 48 months (P < 0.005). There were no serious complications of the 
      procedure. LIMITATIONS: This is an uncontrolled, nonrandomized case series in 
      consecutive patients that does not include long-term pH or motility studies. 
      CONCLUSIONS: This study in drug-refractory patients with GERD found the Stretta 
      procedure to be a safe, effective, and durable treatment that produced 
      significant improvements in heartburn and quality of life and decreased 
      medication usage during a 4-year period of follow-up.
FAU - Noar, Mark D
AU  - Noar MD
AD  - Heartburn and Reflux Study Center, Endoscopic Microsurgery Associates, 7402 York 
      Road, Towson, MD 21204, USA.
FAU - Lotfi-Emran, Sahar
AU  - Lotfi-Emran S
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
RN  - 0 (Enzyme Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
CIN - Gastrointest Endosc. 2007 Mar;65(3):373-4. PMID: 17321233
CIN - Gastrointest Endosc. 2007 Mar;65(3):375-6. PMID: 17321234
CIN - Nat Clin Pract Gastroenterol Hepatol. 2007 Dec;4(12):654-5. PMID: 17971797
MH  - Adult
MH  - Aged
MH  - Catheter Ablation/*methods
MH  - Endoscopy, Gastrointestinal
MH  - Enzyme Inhibitors/*therapeutic use
MH  - Esophagus/metabolism/physiopathology
MH  - Female
MH  - Follow-Up Studies
MH  - Gastric Acidity Determination
MH  - *Gastroesophageal Reflux/drug therapy/psychology/surgery
MH  - Gastrointestinal Motility
MH  - Humans
MH  - Hydrogen-Ion Concentration
MH  - Male
MH  - Middle Aged
MH  - Patient Satisfaction
MH  - Prospective Studies
MH  - *Proton Pump Inhibitors
MH  - *Quality of Life
MH  - Surveys and Questionnaires
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2007/02/27 09:00
MHDA- 2007/04/06 09:00
CRDT- 2007/02/27 09:00
PHST- 2006/04/24 00:00 [received]
PHST- 2006/11/04 00:00 [accepted]
PHST- 2007/02/27 09:00 [pubmed]
PHST- 2007/04/06 09:00 [medline]
PHST- 2007/02/27 09:00 [entrez]
AID - S0016-5107(06)03229-9 [pii]
AID - 10.1016/j.gie.2006.11.015 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2007 Mar;65(3):367-72. doi: 10.1016/j.gie.2006.11.015.