Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Nov;26(11):3307-15.
doi: 10.1007/s00464-012-2324-2. Epub 2012 May 31.

Transoral incisionless fundoplication for treatment of gastroesophageal reflux disease in clinical practice

Bart P L Witteman  1 , Rob Strijkers, Eva de Vries, Liza Toemen, José M Conchillo, Wim Hameeteman, Pieter C Dagnelie, Ger H Koek, Nicole D Bouvy
Affiliations

Transoral incisionless fundoplication for treatment of gastroesophageal reflux disease in clinical practice

Bart P L Witteman et al. Surg Endosc. 2012 Nov.

Abstract

Background: Transoral 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.

Methods: A 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.

Results: Gastroesophageal 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 %.

Conclusions: Endoluminal 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.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Study timeline
See this image and copyright information in PMC

References

    1. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101:1900–1920. doi: 10.1111/j.1572-0241.2006.00630.x. - DOI - PubMed
    1. Jones R, Bytzer P. Review article: acid suppression in the management of gastro-oesophageal reflux disease—an appraisal of treatment options in primary care. Aliment Pharmacol Ther. 2001;15:765–772. doi: 10.1046/j.1365-2036.2001.00985.x. - DOI - PubMed
    1. Spicak J. Treatment of gastroesophageal reflux disease: endoscopic aspects. Dig Dis. 2007;25:183–187. doi: 10.1159/000103882. - DOI - PubMed
    1. Tytgat GN, McColl K, Tack J, Holtmann G, Hunt RH, Malfertheiner P, Hungin AP, Batchelor HK. New algorithm for the treatment of gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2008;27:249–256. doi: 10.1111/j.1365-2036.2007.03565.x. - DOI - PubMed
    1. Garcia Rodriguez LA, Ruigomez A, Panes J. Use of acid-suppressing drugs and the risk of bacterial gastroenteritis. Clin Gastroenterol Hepatol. 2007;5:1418–1423. doi: 10.1016/j.cgh.2007.09.010. - DOI - PubMed