Transoral incisionless fundoplication for gastroesophageal reflux disease in an unselected patient population

Sebastian V. Demyttenaere, Simon Bergman, Thomas Pham, Joel Anderson, Rebecca Dettorre, W. Scott Melvin, Dean J. Mikami

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39 Scopus citations

Abstract

Background: EsophyX is an endolumenal approach to the treatment of gastroesophageal reflux disease (GERD). This report describes one of the earliest and largest North American experiences with this device. Methods Prospective data were gathered on consecutive patients undergoing EsophyX fundoplication for a 1-year period between September 2007 and March 2009. During this time, the procedure evolved to the current technique. A P value less than 0.05 was considered significant. Results: The study enrolled 26 patients with a mean age of 45 years. The patients included 16women (62%)with a mean body mass index (BMI) of 28 and an American Society Anesthesiology (ASA) classification of 2. These patients included 11 with associated small hiatal hernias, 3 with Barrett's esophagus, and 5 with esophageal dysmotility. The procedure time was 65 min (range, 29-137 min), and the length of hospital stay was 1 day (range, 0-6 days). The postoperative valve circumference was 217°, and the valve length was 2.7 cm. Two complications of postoperative bleed occurred, requiring transfusion. The mean follow-up period was 10 months. Comparison of pre- and postoperative Anvari scores (34-17; P = 0.002) and Velanovich scores (22-10; P = 0.0007) showed significant decreases. Although 68% of the patients were still taking antireflux medications, 21% had reduced their dose by half. Three patients had persistent symptoms requiringNissen fundoplication, and there was one late death unrelated to the procedure. Conclusion This study represents an initial single-institution experience with EsophyX. According to the findings, 53% of the patients had either discontinued their antireflux medication (32%) or had decreased their dose by half (21%). Both symptoms and health-related quality-of-life (HRQL) scores significantly improved after treatment. Further follow- up evaluation and objective testing are required.

Original languageEnglish (US)
Pages (from-to)854-858
Number of pages5
JournalSurgical endoscopy
Volume24
Issue number4
DOIs
Publication statusPublished - Apr 2010
Externally publishedYes

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Keywords

  • EsophyX
  • Gastroesophageal reflux disease (GERD)
  • Transoral incisionless fundoplication

ASJC Scopus subject areas

  • Surgery

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