Transoral Fundoplication Can Be Effective Against GERD Symptoms
Key clinical point: Transoral esophagogastric fundoplication (TF) is an effective treatment for gastroesophageal reflux disease symptoms, particularly in patients with persistent regurgitation despite proton pump inhibitor therapy (PPI).
Major finding: Of patients who received TF, 67% experienced elimination of adverse regurgitation, compared with 45% of those treated with PPI (P = .023).
Data source: Randomized EsophyX vs Sham, Placebo-Controlled Transoral Fundoplication (RESPECT) trial.
Disclosures: Several coauthors disclosed ties with the study sponsor EndoGastric Solutions of Redmond, Wash., as well as individual potential conflicts of interest.
FROM GASTROENTEROLOGY
Results showed that 67% of patients who received TF treatment experienced elimination of adverse regurgitation vs. 45% of those treated with PPI (P = .023). Control of esophageal pH also improved noticeably in patients who received TF treatment versus those who did not (9.3% vs. 6.3% on average, respectively, P < .001), but not in patients who received the “sham surgery” (8.6% preop vs. 8.9% postop on average). Fewer patients who received TF treatment recorded having “no response” after 3 months compared with those in the control group (11% vs. 36%, respectively, P = .004).
“Transoral fundoplication may fill the ‘therapeutic gap’ that exists between PPI and laparoscopic fundoplication,” wrote the authors. “Considering the virtual absence of dysphagia and bloating after TF, which may be problematic with LINX [LINX Reflux Management System], it would appear that TF is an option for patients with troublesome regurgitation, as well as for patients with troublesome GERD symptoms who wish not to take PPI over a protracted period of time.”
Several coauthors disclosed ties with the study sponsor EndoGastric Solutions of Redmond, Wash., as well as individual potential conflicts of interest.
