PMID- 36402203
OWN - NLM
STAT- MEDLINE
DCOM- 20230223
LR  - 20240302
IS  - 1097-6779 (Electronic)
IS  - 0016-5107 (Print)
IS  - 0016-5107 (Linking)
VI  - 97
IP  - 3
DP  - 2023 Mar
TI  - Impact of second-generation transoral incisionless fundoplication on atypical 
      GERD symptoms: a systematic review and meta-analysis.
PG  - 394-406.e2
LID - S0016-5107(22)02139-3 [pii]
LID - 10.1016/j.gie.2022.11.002 [doi]
AB  - BACKGROUND AND AIMS: Transoral incisionless fundoplication (TIF) using the 
      EsophyX device (EndoGastric Solutions, Inc, Redmond, Wash, USA) is a minimally 
      invasive endoscopic fundoplication technique. Our study aimed to assess the 
      efficacy of TIF for atypical GERD symptoms in patients with chronic or refractory 
      GERD. METHODS: A systematic search of 4 major databases was performed. All 
      original studies assessing atypical GERD using a validated symptom questionnaire 
      (the reflux symptom index [RSI]) were included. The RSI score was assessed before 
      and after TIF at a 6- and 12-month follow-up. Data on technical success rate, 
      adverse events, proton pump inhibitor (PPI) use, and patient satisfaction were 
      also collected. Only TIF procedures currently in practice using the EsophyX 
      device (ie, TIF 2.0) and TIF with concomitant hiatal hernia repair were included 
      in the review. RESULTS: Ten studies (564 patients) were included. At the 6- and 
      12- month follow-up, there was a mean reduction of 15.72 (95% confidence 
      interval, 12.15-19.29) and 14.73 (95% confidence interval, 11.74-17.72) points, 
      respectively, in the RSI score post-TIF, with a technical success rate of 99.5% 
      and a pooled adverse event rate of 1%. At both time intervals, more than 
      two-thirds of the patients were satisfied with their health condition and roughly 
      three-fourths of the patients were off daily PPIs. CONCLUSIONS: Our study shows 
      that TIF using the EsophyX device is safe and effective in reducing atypical GERD 
      symptoms at 6 and 12 months of follow-up. It improves patient-centered outcomes 
      and can be a minimally invasive therapeutic option for patients suffering from 
      atypical GERD symptoms on chronic medical therapy.
CI  - Copyright (c) 2023 American Society for Gastrointestinal Endoscopy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Haseeb, Muhammad
AU  - Haseeb M
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, Massachusetts, USA; Harvard Medical 
      School, Boston, Massachusetts, USA.
FAU - Brown, Jeremy R Glissen
AU  - Brown JRG
AD  - Division of Gastroenterology, Duke University Medical Center, Durham, North 
      Carolina, USA.
FAU - Hayat, Umar
AU  - Hayat U
AD  - Department of Internal Medicine, University of Kansas School of Medicine, 
      Wichita, Kansas, USA.
FAU - Bay, Camden
AU  - Bay C
AD  - Harvard Medical School, Boston, Massachusetts, USA.
FAU - Bain, Paul A
AU  - Bain PA
AD  - Harvard Medical School, Boston, Massachusetts, USA.
FAU - Jirapinyo, Pichamol
AU  - Jirapinyo P
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, Massachusetts, USA; Harvard Medical 
      School, Boston, Massachusetts, USA.
FAU - Thompson, Christopher C
AU  - Thompson CC
AD  - Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's 
      Hospital, Harvard Medical School, Boston, Massachusetts, USA; Harvard Medical 
      School, Boston, Massachusetts, USA.
LA  - eng
GR  - P30 DK034854/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20221117
PL  - United States
TA  - Gastrointest Endosc
JT  - Gastrointestinal endoscopy
JID - 0010505
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Humans
MH  - *Fundoplication/methods
MH  - Treatment Outcome
MH  - *Gastroesophageal Reflux/drug therapy
MH  - Patient Satisfaction
MH  - Proton Pump Inhibitors/therapeutic use
PMC - PMC10201409
MID - NIHMS1851132
COIS- Conflict of Interest: MH: None JGB: None UH: None CB: None PAB: None PJ: has 
      received research support from Apollo Endosurgery, Fractyl and GI Dynamics, has 
      served as a consultant to Endogastric Solutions and GI Dynamics, has received an 
      honorarium from Obalon Therapeutics, and has received in-kind support from USGI 
      Medical. CCT: is a consultant and received research support from Apollo 
      Endosurgery, Boston Scientific, Fujifilm, GI Dynamics, Lumendi, Olympus, USGI 
      Medical. Consultant for Medtronic and Fractyl. Institutional research grants from 
      Aspire Bariatrics and ERBE. General partner for BlueFlame Healthcare. 
      Founder/Consultant/Board Member for Envision Endoscopy, Enterasense and GI 
      Windows.
EDAT- 2022/11/20 06:00
MHDA- 2023/02/25 06:00
PMCR- 2024/03/01
CRDT- 2022/11/19 19:23
PHST- 2022/06/28 00:00 [received]
PHST- 2022/10/24 00:00 [revised]
PHST- 2022/11/07 00:00 [accepted]
PHST- 2022/11/20 06:00 [pubmed]
PHST- 2023/02/25 06:00 [medline]
PHST- 2022/11/19 19:23 [entrez]
PHST- 2024/03/01 00:00 [pmc-release]
AID - S0016-5107(22)02139-3 [pii]
AID - 10.1016/j.gie.2022.11.002 [doi]
PST - ppublish
SO  - Gastrointest Endosc. 2023 Mar;97(3):394-406.e2. doi: 10.1016/j.gie.2022.11.002. 
      Epub 2022 Nov 17.