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Surgical Endoscopy

, Volume 26, Issue 11, pp 3307–3315

First Online: 31 May 2012Received: 12 June 2011Accepted: 12 April 2012


BackgroundTransoral incisionless fundoplication is a recently introduced endoluminal technique for the treatment of gastroesophageal reflux disease GERD. The objective of this study was to determine outcomes in chronic GERD patients who were referred for surgical management.

MethodsA cohort of 38 patients underwent transoral incisionless fundoplication TIF in a tertiary care setting. Pre- and post-procedure assessment included GERD-related quality of life questionnaires, proton pump inhibitor PPI usage, 24-h pH measurements, upper gastrointestinal endoscopy, esophageal manometry, and registration of adverse events. Duration of follow-up was 36 months.

ResultsGastroesophageal valves were constructed of 4 cm range, 4–6 in length and 220° range, 180–240 in circumference. One serious adverse event occurred, consisting of intraluminal bleeding at a fastener site. Hiatal hernia was completely reduced in 56 % and esophagitis was cured in 47 % of patients. Postprocedure esophageal acid exposure did not significantly improve p > 0.05. At 36 range, 29–41 months follow-up 14 patients 36 % had undergone revisional laparoscopic fundoplication. Quality of life scores of the remaining cohort showed significant improvement p < 0.0001 and daily use of antisecretory medication was discontinued by 74 %.

ConclusionsEndoluminal fundoplication improved quality of life and reduced the need for PPIs in only a subgroup of patients at 3 years follow-up. The amount of patients requiring additional medication and revisional surgery was high.

KeywordsEndoscopy Fundoplication GERD AbbreviationsGERDGastroesophageal reflux disease

TIFTransoral incisionlessfundoplication

PPIProton pump inhibitor

This work was presented at the annual meeting of the Dutch Society of Gastroenterology and Gastro-Intestinal Surgery in October 2010.

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Autor: Bart P. L. Witteman - Rob Strijkers - Eva de Vries - Liza Toemen - José M. Conchillo - Wim Hameeteman - Pieter C. Dag


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