PMID- 19153320
OWN - NLM
STAT- MEDLINE
DCOM- 20090211
LR  - 20090120
IS  - 1538-3644 (Electronic)
IS  - 0004-0010 (Linking)
VI  - 144
IP  - 1
DP  - 2009 Jan
TI  - Endoluminal full-thickness plication and radiofrequency treatments for GERD: an 
      outcomes comparison.
PG  - 19-24; discussion 24
LID - 10.1001/archsurg.144.1.19 [doi]
AB  - 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.
FAU - Jeansonne, Louis O 4th
AU  - Jeansonne LO 4th
AD  - Emory University School of Medicine, Emory Endosurgery Unit, 1364 Clifton Rd, Ste 
      H124, Atlanta, GA 30322, USA. lou@jeansonne.com
FAU - White, Brent C
AU  - White BC
FAU - Nguyen, Vien
AU  - Nguyen V
FAU - Jafri, Syed M
AU  - Jafri SM
FAU - Swafford, Vickie
AU  - Swafford V
FAU - Katchooi, Mina
AU  - Katchooi M
FAU - Khaitan, Leena
AU  - Khaitan L
FAU - Davis, S Scott
AU  - Davis SS
FAU - Smith, C Daniel
AU  - Smith CD
FAU - Sedghi, Shahriar
AU  - Sedghi S
FAU - Lin, Edward
AU  - Lin E
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Arch Surg
JT  - Archives of surgery (Chicago, Ill. : 1960)
JID - 9716528
SB  - IM
MH  - Adult
MH  - Catheter Ablation/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Fundoplication/*methods
MH  - Gastroesophageal Reflux/*surgery
MH  - *Gastroscopy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Treatment Outcome
EDAT- 2009/01/21 09:00
MHDA- 2009/02/12 09:00
CRDT- 2009/01/21 09:00
PHST- 2009/01/21 09:00 [entrez]
PHST- 2009/01/21 09:00 [pubmed]
PHST- 2009/02/12 09:00 [medline]
AID - 144/1/19 [pii]
AID - 10.1001/archsurg.144.1.19 [doi]
PST - ppublish
SO  - Arch Surg. 2009 Jan;144(1):19-24; discussion 24. doi: 10.1001/archsurg.144.1.19.