PMID- 34378427
OWN - NLM
STAT- MEDLINE
DCOM- 20220516
LR  - 20220516
IS  - 1943-572X (Electronic)
IS  - 0003-4894 (Linking)
VI  - 131
IP  - 6
DP  - 2022 Jun
TI  - Response of Laryngopharyngeal Symptoms to Transoral Incisionless Fundoplication 
      in Patients with Refractory Proven Gastroesophageal Reflux.
PG  - 662-670
LID - 10.1177/00034894211037414 [doi]
AB  - OBJECTIVE: Patients with laryngopharyngeal reflux (LPR) symptoms may not respond 
      to proton pump inhibitors (PPI) if they have an alternative laryngeal diagnosis 
      or high-volume reflux. Transoral incisionless fundoplication (TIF) or TIF with 
      concomitant hiatal hernia repair (cTIF) are effective in decreasing symptoms of 
      gastroesophageal reflux disease (GERD) but are not well studied in patients with 
      LPR symptoms. This prospective multicenter study assessed the patient-reported 
      and clinical outcomes after TIF/cTIF in patients with LPR symptoms and proven 
      GERD. METHODS: Patients with refractory LPR symptoms (reflux symptom index 
      [RSI] > 13) and with erosive esophagitis, Barrett's esophagus, and/or pathologic 
      acid reflux by distal esophageal pH testing were evaluated before and after a 
      minimum of 6 months after TIF/cTIF. The primary outcome was normalization of RSI. 
      Secondary outcomes were >50% improvement in GERD-Health-Related Quality of Life 
      (GERD-HRQL), normalization of esophageal acid exposure time, discontinuation of 
      PPI, and patient satisfaction. RESULTS: Forty-nine patients had TIF (n = 26) or 
      cTIF (n = 23) with at least 6 months follow-up. Mean pre- and post TIF/cTIF RSI 
      were 23.6 and 5.9 (mean difference: 17.7, P < .001). Post TIF/cTIF, 90% of 
      patients had improved GERD-HQRL score, 85% normalized RSI, 75% normalized 
      esophageal acid exposure time, and 80% discontinued PPI. No serious 
      procedure-related adverse events occurred. Patient satisfaction was 4% prior to 
      TIF/cTIF and 73% after TIF/cTIF (P < .001). CONCLUSION: In patients with 
      objective evidence of GERD, TIF, or cTIF are safe and effective in controlling 
      LPR symptoms as measured by normalization of RSI and improvement in patient 
      satisfaction after TIF/cTIF. LEVEL OF EVIDENCE: Level 4.
FAU - Snow, Grace E
AU  - Snow GE
AUID- ORCID: 0000-0001-6246-0035
AD  - Division of Laryngology, Department of Otolaryngology-Head & Neck Surgery, Johns 
      Hopkins University School of Medicine, Baltimore, MD, USA.
FAU - Dbouk, Mohamad
AU  - Dbouk M
AD  - Division of Gastrointestinal and Liver Pathology, Department of Pathology, Johns 
      Hopkins University School of Medicine, Baltimore, MD, USA.
FAU - Akst, Lee M
AU  - Akst LM
AUID- ORCID: 0000-0002-8925-0545
AD  - Division of Laryngology, Department of Otolaryngology-Head & Neck Surgery, Johns 
      Hopkins University School of Medicine, Baltimore, MD, USA.
FAU - Ihde, Glenn
AU  - Ihde G
AD  - Department of General Surgery, The Matagorda Regional Medical Group, Bay City, 
      TX, USA.
FAU - Zarnegar, Rasa
AU  - Zarnegar R
AD  - Weill Cornell Medical College, New York, NY, USA.
FAU - Janu, Peter
AU  - Janu P
AD  - Department of Surgery, Fox Valley Surgical Associates, Appleton, WI, USA.
FAU - Murray, Michael
AU  - Murray M
AD  - Department of Surgery, Northern Nevada Medical Center, Sparks, NV, USA.
FAU - Eskarous, Hany
AU  - Eskarous H
AD  - Department of Medicine, Easton Hospital, Easton, PA, USA.
FAU - Sohagia, Amit
AU  - Sohagia A
AD  - Department of Medicine, Easton Hospital, Easton, PA, USA.
FAU - Dhar, Shumon I
AU  - Dhar SI
AD  - Division of Laryngology, Department of Otolaryngology-Head & Neck Surgery, Johns 
      Hopkins University School of Medicine, Baltimore, MD, USA.
FAU - Irene Canto, Marcia
AU  - Irene Canto M
AD  - Division of Gastroenterology, Department of Medicine and Oncology, Johns Hopkins 
      University School of Medicine, Baltimore, MD, USA.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20210811
PL  - United States
TA  - Ann Otol Rhinol Laryngol
JT  - The Annals of otology, rhinology, and laryngology
JID - 0407300
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - *Fundoplication/adverse effects
MH  - Humans
MH  - *Laryngopharyngeal Reflux/complications/diagnosis
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Quality of Life
MH  - Treatment Outcome
OTO - NOTNLM
OT  - gastroesophageal reflux disease
OT  - laryngopharyngeal reflux
OT  - transoral incisionless fundoplication
EDAT- 2021/08/12 06:00
MHDA- 2022/05/17 06:00
CRDT- 2021/08/11 08:45
PHST- 2021/08/12 06:00 [pubmed]
PHST- 2022/05/17 06:00 [medline]
PHST- 2021/08/11 08:45 [entrez]
AID - 10.1177/00034894211037414 [doi]
PST - ppublish
SO  - Ann Otol Rhinol Laryngol. 2022 Jun;131(6):662-670. doi: 
      10.1177/00034894211037414. Epub 2021 Aug 11.