title: Radiofrequency energy delivery to the lower esophageal sphincter (Stretta procedure) does not provide long-term symptom control.
abstract: The Stretta procedure (radiofrequency energy application to the lower esophageal sphincter) is a unique endoluminal technique for the management of gastroesophageal reflux. This article reports on the long-term effectiveness of the Stretta procedure in patients with significant gastroesophageal reflux disease (GERD) referred to a surgical practice. Patients who underwent Stretta with a minimum of 36 months follow-up were included. Thirty-two patients with an average follow-up of 53 months were included; 19 proceeded to anti-reflux surgery. Those not undergoing surgery showed a significant improvement in their GERD satisfaction from 3.14 to 1.46 (P = .0006) but had significantly lower preprocedure heartburn scores (2.43) than those who proceeded to surgery (3.66, P = .0401). The Stretta procedure was effective in reducing symptoms in 40% of patients. Responders had less severe preoperative heartburn. Radiofrequency energy delivery to the lower esophageal sphincter may be effective in selected patients for the treatment of gastroesophageal reflux.
authors.affiliation: Center for Minimally Invasive Surgery, Department of Surgery, The Ohio State University, Columbus 43210, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Dundon
authors.forename: Steven S
authors.initials: SS
authors.lastname: Davis
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Hazey
authors.forename: Vimal
authors.initials: V
authors.lastname: Narula
authors.forename: Peter
authors.initials: P
authors.lastname: Muscarella
authors.forename: William Scott
authors.initials: WS
authors.lastname: Melvin
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D049630:Esophageal Sphincter, Lower; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000150:complications / Q000601:surgery*; D006356:Heartburn / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult