title: Early and Midterm Outcome After Laparoscopic Fundoplication and a Minimally Invasive Endoscopic Procedure in Patients with Gastroesophageal Reflux Disease: A Prospective Observational Study.
abstract: OBJECTIVE
  Although the minimally invasive endoscopic Stretta procedure is being increasingly used as an alternative strategy to manage gastroesophageal reflux disease (GERD), the benefits of this procedure have to be further evaluated in clinical settings. This prospective observational study assessed the short-term and midterm outcomes associated with laparoscopic Toupet fundoplication (LTF) and the Stretta procedure.
  
  
  METHODS
  From January 2011 to January 2012, we allocated 80 patients to LTF and 85 to the Stretta procedure. Primary outcome measures, including symptom scores of heartburn, regurgitation, chest pain, belching, hiccup, cough, and asthma, as well as proton pump inhibitor (PPI) use, were analyzed at midterm follow-up (1-3 years).
  
  
  RESULTS
  Of the 165 patients, 125 patients following LTF (n=65) or the Stretta procedure (n=60) completed the designated 3-year follow-up and were included in the final analysis. At the end of the 3-year follow-up, the symptom scores were all significantly decreased compared with the corresponding values before the two procedures in both groups (P<.05). After LTF and the Stretta procedure, 47/65 (72.3%) and 41/60 (68.3%) patients, respectively, achieved complete PPI therapy independence (72.3% versus 68.3%, P=.627). Comparing with LTF, however, the Stretta procedure had less effect on improving typical symptoms of heartburn, regurgitation, and chest pain and reducing the rate of re-operation (11.8% versus 0%, P=.006).
  
  
  CONCLUSIONS
  LTF and the Stretta procedure were equally effective in controlling GERD symptoms and reducing PPI use. However, LTF can achieve more improvement on typical symptoms and has a lower rate of re-operation.
authors.affiliation: 1 Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University , Beijing, China .
authors.forename: Wei-Tao
authors.initials: WT
authors.lastname: Liang
authors.affiliation: 1 Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University , Beijing, China .
authors.forename: Chao
authors.initials: C
authors.lastname: Yan
authors.affiliation: 1 Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University , Beijing, China .
authors.forename: Zhong-Gao
authors.initials: ZG
authors.lastname: Wang
authors.affiliation: 2 Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army , Beijing, China .
authors.forename: Ji-Min
authors.initials: JM
authors.lastname: Wu
authors.affiliation: 2 Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army , Beijing, China .
authors.forename: Zhi-Wei
authors.initials: ZW
authors.lastname: Hu
authors.affiliation: 2 Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army , Beijing, China .
authors.forename: Xiu-Lan
authors.initials: XL
authors.lastname: Zhan
authors.affiliation: 2 Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army , Beijing, China .
authors.forename: Feng
authors.initials: F
authors.lastname: Wang
authors.affiliation: 2 Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army , Beijing, China .
authors.forename: Song-Song
authors.initials: SS
authors.lastname: Ma
authors.affiliation: 2 Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army , Beijing, China .
authors.forename: Mei-Ping
authors.initials: MP
authors.lastname: Chen
mesh_terms: D000328:Adult; D002637:Chest Pain / Q000209:etiology; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004884:Eructation / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D006356:Heartburn / Q000209:etiology; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D057045:Laryngopharyngeal Reflux / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors