title: Effect of transoral incisionless fundoplication on symptoms, PPI use, and ph-impedance refluxes of GERD patients.
abstract: BACKGROUND
  Three previous studies from the same institution have reported that transoral incisionless fundoplication (TIF) with the EsophyX device is effective for creating a continent gastroesophageal valve and for good functional results as measured only by pH-metry in patients with gastroesophageal reflux disease (GERD). The objective of the present study was to evaluate the effect of TIF on symptoms, use of proton pump inhibitors (PPI), esophageal motility, and pH-impedance in patients with symptomatic GERD.
  
  
  METHODS
  Twenty consecutive patients were enrolled to complete the GERD-HRQL and GERD-QUAL questionnaires while on and off PPI. They were also examined by upper gastrointestinal (GI) endoscopy to determine Hill grade and Jobe length of the gastroesophageal valve, and to check for hiatal hernia and esophagitis, esophageal manometry, and pH-impedance before and 6 months after TIF.
  
  
  RESULTS
  Six months after TIF, the GERD-HRLQ and GERD-QUAL scores off-PPI therapy and the number of total and acid pH-impedance refluxes were significantly reduced (p < 0.05). The PPI had been completely stopped in 55% of the patient and was reduced in 22% of the patients.
  
  
  CONCLUSIONS
  At 6-month follow-up, TIF performed using the EsophyX device reduces symptoms and pH-impedance refluxes, allowing interruption or reduction of PPI use in 78% of patients with GERD.
authors.affiliation: Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, via Olgettina 58, 20132, Milan, Italy. testoni.pieralberto@hsr.it
authors.forename: Pier Alberto
authors.initials: PA
authors.lastname: Testoni
authors.forename: Maura
authors.initials: M
authors.lastname: Corsetti
authors.forename: Salvatore
authors.initials: S
authors.lastname: Di Pietro
authors.forename: Antonio Gianluca
authors.initials: AG
authors.lastname: Castellaneta
authors.forename: Cristian
authors.initials: C
authors.lastname: Vailati
authors.forename: Enzo
authors.initials: E
authors.lastname: Masci
authors.forename: Sandro
authors.initials: S
authors.lastname: Passaretti
mesh_terms: D050782:Esophageal pH Monitoring; D005260:Female; D018662:Fundoplication / Q000379:methods*; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000008:administration & dosage*; D011788:Quality of Life; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors