title: Endoluminal fundoplication (ELF) for GERD using EsophyX: a 12-month follow-up in a single-center experience.
abstract: BACKGROUND
  Several endoscopic antireflux therapies have been proposed to reduce the need for chronic medical therapy or laparoscopic fundoplication for gastroesophageal reflux disease (GERD). Aim of this study was to evaluate the short- and mid-term clinical results of endoluminal fundoplication (ELF) with EsophyX.
  
  
  METHODS
  From June 2006 to April 2008, 20 patients were enrolled in the study. All the ELFs were performed under general anesthesia.
  
  
  RESULTS
  The mean duration of the procedure was 63 min (range 38-105). A median of 14 fasteners was placed. There were no major intraoperative complications. Two patients developed early complications and were treated conservatively. Four patients underwent, within the first year post-ELF, a laparoscopic fundoplication because of persistence of symptoms. One patient was lost to follow-up between 6 and 12 months. Among the other 15 patients who completed 12 months follow-up, the GERD health-related quality of life score decreased from a median of 40 to a median of 10 (p < 0.05), and seven patients were still off proton pump inhibitor. An improvement in esophageal acid exposure was recorded in 16.6% of patients, while in 66.7%, it worsened.
  
  
  CONCLUSIONS
  ELF induced improvement of GERD symptoms and patients quality of life in a subgroup of patients with a reduced need for medication. However, it did not significantly change esophageal acid exposure in these patients. The need for revisional standard laparoscopic fundoplication was high.
authors.affiliation: Department of Gastroenterology and Digestive Endoscopy, IRCCS Istituto Clinico Humanitas, 20089 Milan, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Repici
authors.forename: Uberto
authors.initials: U
authors.lastname: Fumagalli
authors.forename: Alberto
authors.initials: A
authors.lastname: Malesci
authors.forename: Roberta
authors.initials: R
authors.lastname: Barbera
authors.forename: Camilla
authors.initials: C
authors.lastname: Gambaro
authors.forename: Riccardo
authors.initials: R
authors.lastname: Rosati
mesh_terms: D000328:Adult; D000368:Aged; D016099:Endoscopy, Gastrointestinal; D005260:Female; D018662:Fundoplication / Q000295:instrumentation* / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications