title: Transoral incisionless fundoplication offers high patient satisfaction and relief of therapy-resistant typical and atypical symptoms of GERD in community practice.
abstract: This retrospective study evaluated clinical outcomes in 124 consecutive gastroesophageal reflux disease (GERD) patients who underwent transoral incisionless fundoplication (TIF) at 2 community hospitals. Out of 123 patients treated successfully, 110 gave consent (74% female, median age 60 [range 21-87] years, body mass index 27.5 [19.0-47.9]). At a median 7-month follow-up (range 5-17), typical and atypical symptom scores were normalized in 75% to 80% of patients, proton pump inhibitors (PPIs) were completely discontinued by 93%, and 83% were satisfied with their current health condition. Endoscopy in 53 patients revealed Hill grade I tight valves in 89% of the cases, reduced hiatal hernia in 33/34 (97%), and healed reflux esophagitis in 25/30 (83%). Based on global analysis, 72% of the patients were in remission, 20% improved symptomatically, and only 8% had ongoing GERD. These results supported the safety and efficacy of TIF as well as encouraged its application as an alternative treatment of GERD refractory to PPIs.
authors.affiliation: Livingston Hospital and Healthcare Services, Inc, Salem, KY, USA. wbarnes@tririvershc.com
authors.forename: William E
authors.initials: WE
authors.lastname: Barnes
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Hoddinott
authors.forename: Stephanie
authors.initials: S
authors.lastname: Mundy
authors.forename: Madeline
authors.initials: M
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004351:Drug Resistance; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery*; D006764:Hospitals, Community; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009055:Mouth; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D010149:Postoperative Pain; D017060:Patient Satisfaction; D054328:Proton Pump Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D054328:Proton Pump Inhibitors