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 »

Long-term outcomes after transoral incisionless fundoplication in patients with GERD and LPR symptoms

BACKGROUND: A retrospective study evaluated safety, symptom resolution, patient satisfaction, and medication use 1-2 years after transoral incisionless fundoplication (TIF) in patients with gastroesophageal reflux disease (GERD) and/or laryngopharyngeal reflux (LPR) symptoms. METHODS: Thirty-four patients with a confirmed diagnosis of GERD symptoms that were inadequately controlled by antisecretory medications, and who where either dissatisfied with… Read more »

Endoscopic fundoplication for the treatment of gastroesophageal reflux disease: Initial experience

OBJECTIVE: Transoral incisionless fundoplication (TIF) is a promising approach for gastroesophageal reflux disease (GERD) that may decrease morbidity compared with conventional anti reflux procedures. We report our initial experience with this minimally invasive approach. METHODS: Over a 24-month period, 46 patients (mean age, 49 years; 50% female) underwent 48 TIF procedures. All procedures were performed… Read more »

Short-term safety and symptomatic outcomes of transoral incisionless fundoplication with or without hiatal hernia repair in patients with chronic gastroesophageal reflux disease

BACKGROUND: A retrospective community-based study evaluated the safety and symptomatic outcomes of the transoral incisionless fundoplication (TIF) procedure with or without hiatal hernia repair (HHR) in patients with chronic gastroesophageal reflux disease (GERD). MATERIALS AND METHODS: Forty-eight patients underwent TIF using EsophyX (EndoGastric Solutions, Redmond, WA) in 3 community hospitals. Patients who presented with a… 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 »

Transoral incisionless esophago-gastric fundoplication offers high patient satisfaction and relief of therapy-resistant typical and atypical symptoms of GERD in community practice

This retrospective study evaluated clinical outcomes in 124 consecutive gastroesophageal reflux disease (GERD) patients who underwent transoral incisionless fundoplication (TIF) at 2 community hospitals. Out of 123 patients treated successfully, 110 gave consent (74% female, median age 60 [range 21-87] years, body mass index 27.5 [19.0-47.9]). At a median 7-month follow-up (range 5-17), typical and… Read more »

Clinical and pH-metric outcomes of transoral esophagogastric fundoplication for the treatment of gastroesophageal reflux disease

BACKGROUND: Transoral treatment of gastroesophageal reflux disease (GERD) using the EsophyX device enables creation of an esophagogastric fundoplication with potential for better control of reflux than gastrogastric techniques. Efficacy and safety of a rotational/longitudinal esophagogastric transoral incisionless fundoplication (TIF) was evaluated retrospectively using subjective and objective outcomes. METHODS: Thirty-seven consecutive patients on antisecretory medication and… 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 »

Use of acid-suppressive drugs and risk of fracture: a meta-analysis of observational studies

PURPOSE: Previous studies have reported inconsistent findings regarding the association between the use of acid-suppressive drugs such as proton pump inhibitors (PPIs) and histamine 2 receptor antagonists (H(2)RAs) and fracture risk. We investigated this association using meta-analysis. METHODS: We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library from inception through December 2010 using common key… Read more »