Endoscopic day case antireflux radiofrequency (Stretta) therapy improves quality of life and reduce proton pump inhibitor (PPI) dependency in patients with gastro-oesophageal reflux disease: a prospective study from a UK tertiary centre.

Autor: Viswanath Y; Upper GI Laparoscopic and endoscopic surgery, James Cook University Hospital, Middlesbrough, Cleveland, UK., Maguire N; Upper GI Laparoscopic and endoscopic surgery, James Cook University Hospital, Middlesbrough, Cleveland, UK., Obuobi RB; Upper GI Laparoscopic and endoscopic surgery, James Cook University Hospital, Middlesbrough, Cleveland, UK., Dhar A; Darlington Memorial Hospital, Bishop Auckland, UK., Punnoose S; Darlington Memorial Hospital, Bishop Auckland, UK.; Gastroenterology, County Durham & Darlington NHS FoundationTrust.
Jazyk: angličtina
Zdroj: Frontline gastroenterology [Frontline Gastroenterol] 2019 Apr; Vol. 10 (2), pp. 113-119. Date of Electronic Publication: 2018 Sep 21.
DOI: 10.1136/flgastro-2018-101028
Abstrakt: Background: Endoscopic antireflux radiofrequency treatment (Stretta) offers a therapeutic alternative for patients suffering from refractory gastro-oesophageal reflux disease (GORD). Current evidence suggests that the treatment may improve symptoms of GORD and decrease requirement for proton pump inhibitor (PPI) therapy.
Methods: Prospective assessment of patients undergoing Stretta, between October 2014 and February 2016, in a UK tertiary referral centre was carried. All patients were assessed for suitability using endoscopy, contrast studies, and pH and manometry studies. The Gastro-oesophageal Reflux Disease-Health-Related Quality of Life (GERD-HRQL) was used to evaluate symptoms along with PPI dependency, pre-Stretta and post-Stretta treatment. Patients were followed up by outpatient clinic appointment and telephone consultation.
Results: Fifty consecutive patients were followed up for a median of 771 days (range 499-1162) following treatment with Stretta. The average GERD-HRQL score improved from 46.2/75 (±14.2) preprocedure to 15.2/75 (±17.3) postprocedure. Dissatisfaction with GORD as measured in the GERD-HRQL decreased from 100% to 10% with three patients showing no improvement (non-responders) at follow up and two late failures at the time of this review. There were no complications and all cases were carried out as day cases.
Conclusion: There are currently few effective therapeutic alternatives to antireflux surgery for refractory GORD. This series corroborates the value and safety of Stretta as a viable option for selected patients who are unwilling or unable to undergo an operation. Stretta improves quality of life and decreases PPI dependency in selected patients with GORD.
Competing Interests: Competing interests: None declared.
Databáze: MEDLINE