Stretta as the initial antireflux procedure in children

Donald C. Liu, Stig Somme, Peter G. Mavrelis, Daniel Hurwich, Mindy B. Statter, Daniel H. Teitelbaum, Beth T. Zimmermann, Carl Christian A Jackson, Charles Dye

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

The Stretta procedure is an endoluminal antireflux procedure using radio frequency to induce collagen tissue contraction, remodeling, and modulation of lower esophageal sphincter physiology in an effort to treat gastroesophageal reflux disease (GERD). Although Stretta has been widely reported in the adult GERD literature as a viable initial surgical option, similar use in children has not been reported. The authors present the first report of Stretta as the initial antireflux procedure in children with GERD, evaluating indications, safety, and efficacy. The charts of 8 children (aged 11-16 years) who received Stretta between January 2003 and September 2003 were retrospectively reviewed under an Institutional Review Board protocol. All patients had documented GERD preoperatively. Three children required concomitant feeding tube placement (percutaneous gastrostomy tube, group A). Five children with isolated severe GERD refractory to aggressive medical therapy received Stretta only (group B). Stretta was successfully completed in all 8 children. In group A, 1 child developed a postoperative aspiration, which was successfully treated. All 3 children had resolution of their GERD symptoms (ie, feeding intolerance, emesis) and were able to tolerate full enteral nutrition post-Stretta. In group B, 3 of 5 children are currently off medications and asymptomatic on short-term follow-up (6-15 months). Of the remaining 2, 1 experienced symptomatic relief immediately postprocedure, but symptoms recurred off medications. Stretta was deemed unsuccessful in the remaining patient, and Nissen fundoplication was subsequently performed without difficulty. Stretta can be safely and successfully used as the initial antireflux procedure for children with GERD. Concomitant Stretta with PEG is an attractive option in children with preexisting GERD who require long-term feeding access. Longer follow-up and a larger patient population are needed to better confirm the safety and efficacy of Stretta presented in this report.

Original languageEnglish (US)
Pages (from-to)148-152
Number of pages5
JournalJournal of Pediatric Surgery
Volume40
Issue number1
DOIs
StatePublished - Jan 2005
Externally publishedYes

Fingerprint

Gastroesophageal Reflux
Enteral Nutrition
Safety
Fundoplication
Lower Esophageal Sphincter
Gastrostomy
Research Ethics Committees
Radio
Vomiting
Collagen
Population

Keywords

  • Children
  • Gastroesophageal reflux
  • Radio frequency
  • Stretta

ASJC Scopus subject areas

  • Surgery

Cite this

Liu, D. C., Somme, S., Mavrelis, P. G., Hurwich, D., Statter, M. B., Teitelbaum, D. H., ... Dye, C. (2005). Stretta as the initial antireflux procedure in children. Journal of Pediatric Surgery, 40(1), 148-152. https://doi.org/10.1016/j.jpedsurg.2004.09.032

Stretta as the initial antireflux procedure in children. / Liu, Donald C.; Somme, Stig; Mavrelis, Peter G.; Hurwich, Daniel; Statter, Mindy B.; Teitelbaum, Daniel H.; Zimmermann, Beth T.; Jackson, Carl Christian A; Dye, Charles.

In: Journal of Pediatric Surgery, Vol. 40, No. 1, 01.2005, p. 148-152.

Research output: Contribution to journalArticle

Liu, DC, Somme, S, Mavrelis, PG, Hurwich, D, Statter, MB, Teitelbaum, DH, Zimmermann, BT, Jackson, CCA & Dye, C 2005, 'Stretta as the initial antireflux procedure in children', Journal of Pediatric Surgery, vol. 40, no. 1, pp. 148-152. https://doi.org/10.1016/j.jpedsurg.2004.09.032
Liu, Donald C. ; Somme, Stig ; Mavrelis, Peter G. ; Hurwich, Daniel ; Statter, Mindy B. ; Teitelbaum, Daniel H. ; Zimmermann, Beth T. ; Jackson, Carl Christian A ; Dye, Charles. / Stretta as the initial antireflux procedure in children. In: Journal of Pediatric Surgery. 2005 ; Vol. 40, No. 1. pp. 148-152.
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