title: Endoscopic stapling in comparison to laparoscopic fundoplication for the treatment of gastroesophageal reflux disease.
abstract: BACKGROUND
  The SRS(TM) Endoscopic Stapling System (Medigus Ltd, Omer, Israel) is a novel method for the treatment of gastroesophageal reflux disease (GERD). The present study assessed the safety and efficacy of SRS compared with laparoscopic anti-reflux surgery (LARS).
  
  
  METHODS
  Of 27 participants, 11 underwent SRS and 16 LARS. Symptoms were assessed using Velanovich GERD-health-related quality of life (GERD-HRQL) scores. The groups were compared in reference to operation time, improvement in GERD-HRQL scores, and postoperative course. Chi-squared and Mann-Whitney-U-tests were used for statistical analysis.
  
  
  RESULTS
  Of 16 (59.3%) male and 11 (40.7%) female patients, mean age was 39.6 (range: 24-60) years and mean body mass index was 26.2 kg/m(2) . Both groups were statistically similar. An esophageal perforation observed in the SRS group completely recovered after over-the-scope clipping. Procedure times for SRSand LARS were 89 and 47 min, respectively (P < 0.05). Mean discharge time was longer for SRS than LARS (3 days vs 1.2 days, P < 0.05). However, this difference disappeared with the exclusion of a complicated patient with long hospitalization in the SRS group. During 6 months mean follow up, proton-pump inhibitor use was insignificantly higher in the SRS group (P > 0.05). Mean GERD-HRQL scores dropped in 87% and in 64% of patients (P > 0.05) from 29.3 to 4.1 and from 24.8 to 8.9 (P = 0.016) in LARS and SRS groups, respectively.
  
  
  CONCLUSIONS
  The short-term results of SRS are promising. The forthcoming new-generation devices and increasing experience may further improve efficacy and decrease untoward effects.
authors.affiliation: Department of Gastroenterology, Medical Faculty of Bezmi Alem University, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Danalioglu
authors.forename: Gokhan
authors.initials: G
authors.lastname: Cipe
authors.forename: Toygar
authors.initials: T
authors.lastname: Toydemir
authors.forename: Orhan
authors.initials: O
authors.lastname: Kocaman
authors.forename: Ali Tuzun
authors.initials: AT
authors.lastname: Ince
authors.forename: Mahmut
authors.initials: M
authors.lastname: Muslumanoglu
authors.forename: Hakan
authors.initials: H
authors.lastname: Senturk
mesh_terms: D000328:Adult; D004724:Endoscopy; D005260:Female; D018662:Fundoplication / Q000379:methods; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D017792:Surgical Stapling / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: SRSTM Endoscopic Stapling System; endoscopic therapy; gastroesophageal reflux disease (GERD); laparoscopic anti-reflux surgery (LARS)