Transoral fundoplication for recurrent gastro-oesophageal reflux disease following previous surgical repair

AIM: Transoral fundoplication has been repeatedly shown to be effective in selected patients suffering from gastro-oesophageal reflux disease (GERD) refractory to conservative treatment. In this series the safety and efficacy of this approach was evaluated in a group of patients suffering from recurrent reflux problems following previous surgical antireflux treatment. PATIENTS AND METHODS: From February… Read more »

Reflux parameters as modified by EsophyX or laparoscopic fundoplication in refractory GERD

BACKGROUND: EsophyX is a novel transoral incisionless fundoplication device developed to mimic surgical fundoplication. EsophyX fundoplication improves acid reflux parameters in proton pump inhibitor (PPI)-responsive GERD patients but its efficacy in refractory GERD has been scarcely studied. AIM: To assess reflux parameters before and after EsophyX or laparoscopic fundoplication and their relationship with symptoms in… Read more »

Laparoscopic antireflux surgery vs esomeprazole treatment for chronic GERD: the LOTUS randomized clinical trial

CONTEXT: Gastroesophageal reflux disease (GERD) is a chronic, relapsing disease with symptoms that have negative effects on daily life. Two treatment options are long-term medication or surgery. OBJECTIVE: To evaluate optimized esomeprazole therapy vs standardized laparoscopic antireflux surgery (LARS) in patients with GERD. DESIGN, SETTING, AND PARTICIPANTS: The LOTUS trial, a 5-year exploratory randomized, open,… Read more »

Advances in transoral fundoplication for oesophageal reflux

BACKGROUND: The purpose of this review was to evaluate transoral fundoplication devices for gastro-oesophageal reflux disease that have been commercially available within the last 5 years. METHODS: Literature databases including Medline and Pubmed were searched from January 2005 to November 2010. Both blinded and unblinded randomized studies were evaluated. RESULTS: We reviewed the literature for… Read more »

Laparoscopic Nissen fundoplication after failed EsophyX fundoplication

BACKGROUND: Reflux control may be ineffective in a substantial number of patients after endoluminal EsophyX fundoplication for gastro-oesophageal reflux disease. Subsequent laparoscopic Nissen fundoplication (LNF) might be required to relieve symptoms. The aim of this study was to evaluate the outcome of LNF after previous EsophyX fundoplication. METHODS: EsophyX failure was defined as recurrence or… Read more »

Effect of transoral incisionless fundoplication on symptoms, PPI use, and pH-impedance refluxes of GERD patients.

BACKGROUND: Three previous studies from the same institution have reported that transoral incisionless fundoplication (TIF) with the EsophyX device is effective for creating a continent gastroesophageal valve and for good functional results as measured only by pH-metry in patients with gastroesophageal reflux disease (GERD). The objective of the present study was to evaluate the effect… Read more »