title: Comparison of Stretta procedure and toupet fundoplication for gastroesophageal reflux disease-related extra-esophageal symptoms.
abstract: OBJECTIVE
  To compare the outcomes between the Stretta procedure and laparoscopic toupet fundoplication (LTF) in patients with gastroesophageal reflux disease (GERD)-related extra-esophageal symptoms.
  
  
  METHODS
  From January 2011 to February 2012, a total of 98 patients diagnosed with GERD-related extra-esophageal symptoms who met the inclusion criteria were enrolled in this study. All patients who either underwent the Stretta procedure or LTF treatment have now completed the 3-year follow-up. Primary outcome measures, including frequency and severity of extra-esophageal symptoms, proton pump inhibitor (PPI) use, satisfaction, and postoperative complications, were assessed. The results of the Stretta procedure and LTF therapy were analyzed and compared.
  
  
  RESULTS
  There were 47 patients in the Stretta group and 51 patients in the LTF group. Ninety patients were available at the 3-year follow-up. The total of the frequency and severity scores for every symptom improved in both groups (P < 0.05). Improvement in symptom scores of cough, sputum, and wheezing did not achieve statistical significance between the two groups (P > 0.05). However, the score for globus hysterics was different between the Stretta group and the LTF group (4.9 ± 2.24 vs 3.2 ± 2.63, P < 0.05). After the Stretta procedure and LTF treatment, 29 and 33 patients in each group achieved PPI therapy independence (61.7% vs 64.7%, P = 0.835). The patients in the LTF group were more satisfied with their quality of life than those in the Stretta procedure group (P < 0.05). Most complications resolved without intervention within two weeks; however, two patients in the LTF group still suffered from severe dysphagia 2 wk after the operation, and it improved after bougie dilation treatment in both patients.
  
  
  CONCLUSIONS
  The Stretta procedure and LTF were both safe and effective for the control of GERD-related extra-esophageal symptoms and the reduction of PPI use.
authors.affiliation: Chao Yan, Wei-Tao Liang, Zhong-Gao Wang, Zhi-Wei Hu, Ji-Min Wu, Mei-Ping Chen, Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army, Beijing 100088, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Yan
authors.affiliation: Chao Yan, Wei-Tao Liang, Zhong-Gao Wang, Zhi-Wei Hu, Ji-Min Wu, Mei-Ping Chen, Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army, Beijing 100088, China.
authors.forename: Wei-Tao
authors.initials: WT
authors.lastname: Liang
authors.affiliation: Chao Yan, Wei-Tao Liang, Zhong-Gao Wang, Zhi-Wei Hu, Ji-Min Wu, Mei-Ping Chen, Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army, Beijing 100088, China.
authors.forename: Zhong-Gao
authors.initials: ZG
authors.lastname: Wang
authors.affiliation: Chao Yan, Wei-Tao Liang, Zhong-Gao Wang, Zhi-Wei Hu, Ji-Min Wu, Mei-Ping Chen, Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army, Beijing 100088, China.
authors.forename: Zhi-Wei
authors.initials: ZW
authors.lastname: Hu
authors.affiliation: Chao Yan, Wei-Tao Liang, Zhong-Gao Wang, Zhi-Wei Hu, Ji-Min Wu, Mei-Ping Chen, Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army, Beijing 100088, China.
authors.forename: Ji-Min
authors.initials: JM
authors.lastname: Wu
authors.affiliation: Chao Yan, Wei-Tao Liang, Zhong-Gao Wang, Zhi-Wei Hu, Ji-Min Wu, Mei-Ping Chen, Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army, Beijing 100088, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Chao Yan, Wei-Tao Liang, Zhong-Gao Wang, Zhi-Wei Hu, Ji-Min Wu, Mei-Ping Chen, Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army, Beijing 100088, China.
authors.forename: Mei-Ping
authors.initials: MP
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000009:adverse effects; D005260:Female; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D054328:Proton Pump Inhibitors
keywords: Extra-esophageal symptoms; Gastroesophageal reflux disease; Laparoscopic Toupet fundoplication; Proton pump inhibitor use; Stretta procedure