title: Endoluminal full-thickness plication and radiofrequency treatments for GERD: an outcomes comparison.
abstract: OBJECTIVE
  Endoluminal therapies have emerged as adjuncts for the treatment of gastroesophageal reflux disease (GERD) in select patients.
  
  
  OBJECTIVE
  To compare the effectiveness of endoscopic full-thickness plication and endoscopic radiofrequency treatments for patients with GERD.
  
  
  METHODS
  A total of 126 patients who underwent either endoscopic full-thickness plication (FTP) of the gastric cardia or endoscopic radiofrequency (RF) treatment of the esophagogastric junction during a 4-year period were included (68 underwent RF and 58 underwent FTP).
  
  
  METHODS
  Follow-up data was obtained for 51% of patients (mean follow-up, 6 months).
  
  
  METHODS
  Comparison of medication use, symptom scores, and pH values at baseline and follow-up.
  
  
  RESULTS
  In the RF group, patients with moderate to severe heartburn decreased from 55% to 22% (P < .01), and proton pump inhibitor (PPI) use decreased from 84% to 50% (P = .01). Decreases were also seen for dysphagia, voice symptoms, and cough. Percentage of time the pH was less than 4 was unchanged. In the FTP group, patients with moderate to severe heartburn decreased from 53% to 43% (P = .3), and PPI use decreased from 95% to 43% (P = .01). Percentage of time the pH was less than 4 decreased from 10.0% to 6.1% (P = .05). Decreases were also seen for regurgitation, voice symptoms, and dysphagia. There was no change in scores for chest pain or asthma in either group.
  
  
  CONCLUSIONS
  For patients with GERD, RF and FTP both resulted in a decrease in both PPI use and in scores for voice symptoms and dysphagia. In addition, RF resulted in decreased heartburn and cough, while FTP resulted in the most dramatic reduction in regurgitation. Our experience indicates that both procedures are effective, providing symptomatic relief and reduction in PPI use. For patients whose chief complaint is regurgitation, FTP may be the preferred procedure.
authors.affiliation: Emory University School of Medicine, Emory Endosurgery Unit, 1364 Clifton Rd, Ste H124, Atlanta, GA 30322, USA. lou@jeansonne.com
authors.forename: Louis O
authors.initials: LO
authors.lastname: Jeansonne
authors.forename: Brent C
authors.initials: BC
authors.lastname: White
authors.forename: Vien
authors.initials: V
authors.lastname: Nguyen
authors.forename: Syed M
authors.initials: SM
authors.lastname: Jafri
authors.forename: Vickie
authors.initials: V
authors.lastname: Swafford
authors.forename: Mina
authors.initials: M
authors.lastname: Katchooi
authors.forename: Leena
authors.initials: L
authors.lastname: Khaitan
authors.forename: S Scott
authors.initials: SS
authors.lastname: Davis
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Smith
authors.forename: Shahriar
authors.initials: S
authors.lastname: Sedghi
authors.forename: Edward
authors.initials: E
authors.lastname: Lin
mesh_terms: D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome