Long-term results of the stretta procedure in patients with gastroesophageal reflux: A single-center experience

Yıl 2020, , 1 - 4, 30.04.2020

Mehmet Gök Genco Gençdal

https://doi.org/10.17940/endoskopi.711225

Öz

Background and Aim: Gastroesophageal reflux disease is a common disease that is usually treated with medications. A group of patients who is unresponsive to lifestyle changes and medications or does not want to use long-term medications is referred for endoscopic treatments and surgery. In this study, we aimed to present the results of our patients who were followed up after the diagnosis of gastroesophageal reflux disease and Stretta treatment in our clinic. Materials and Methods: The study included a total of 25 patients with gastroesophageal reflux diseasewith ages between 18 and 80 years who underwent the Stretta procedure. Patients were followed up for 4 years. Results: Of 25 patients, 16 were men (mean age: 38±7.59 years) and 9 women (mean age: 38.2±7.74 years). The heartburn scores were 3.7±0.66 and 1.6±1 (p <0.05) in women and 4±0.70 and 1.68±1.19 (p <0.05) in men before and 12 months after the procedure, respectively. In the 4th year, there was a significant improvement in the reflux symptoms and quality of life of the patients, and 15 (60%) of 25 patients continued their life without using proton pump inhibitors. Conclusion: The Stretta procedure may be a good alternative for patients who do not respond to medicines or respond but refuse to take continuous medications.

Anahtar Kelimeler

Stretta, gastroesophageal reflux, heartburn

Gastroözofageal reflü hastalarında uzun dönem stretta sonuçlarımız: Tek merkez deneyimi

Öz

Giriş ve Amaç: Gastroözofageal reflü yaygın bir hastalıktır ve genellikle ilaçlar ile tedavi edilir. Yaşam tarzı değişikliklerine ve ilaçlarına cevap vermeyen ya da uzun süreli ilaç kullanmak istemeyen bir grup hastaya, endoskopik tedaviler ve cerrahi müdahale önerilir. Bu çalışmada kliniğimizde gastroözofageal reflü tanısı ile takip edilen ve Stretta uygulanmış hastaların sonuçlarını sunmayı amaçladık. Gereç ve Yöntem: Çalışmaya, Stretta işlemi uygulanan 18-80 yaşları arasında gastroözofageal reflü hastalığı olan toplam 25 hasta alındı. Hastalar 4 yıl takip edildi. Bulgular: 25 hastanın 16'sı erkek (yaş ortalaması: 38±7.59) ve 9'u kadındı (yaş ortalaması: 38.2±7.74). Mide ekşimesi skoru (tedaviden önce) kadınlarda 3.7±0.66, erkeklerde 4±0.70 idi. Stretta işleminden sonraki 12. ayda, heartburn skoru kadınlarda 1.6±1 (p <0.05) ve erkeklerde 1.68±1.19 (p <0.05) idi. Dördüncü yılda reflü semptomlarında ve hastaların yaşam kalitesinde belirgin bir düzelme görüldü ve 25 hastanın 15'i (% 60) PPI kullanmadan yaşamlarına devam etti. Sonuç: İlaçlara cevap vermeyen veya ilaçlara cevap vermeyen ancak sürekli ilaç almak istemeyen hastalarda Stretta prosedürü iyi bir alternatif olabilir.

Anahtar Kelimeler

Stretta, gastroözofageal reflü, heartburn

Kaynakça

• 1. Vakil N, van Zanten SV, Kahrilas P, et al. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006;101:1900-20. 2. Dent J, El-Serag HB, Wallander MA, Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 2005;54:710-7. 3. Richter JE. Typical and atypical presentations of gastroesophageal reflux disease. The role of esophageal testing in diagnosis and management. Gastroenterol Clin North Am 1996;25:75-102. 4. Franciosa M, Triadafilopoulos G, Mashimo H. Stretta radiofrequency treatment for GERD. Gastroent Res Pract 2013;783815. 5. Bor S, Mandiracioglu A, Kitapcioglu G, Caymaz-Bor C, Gilbert RJ. Gastroesophageal reflux disease in a low-income region in Turkey. Am J Gastroenterol 2005;100:759-65. 6. Yonem O, Sivri B, Ozdemir L, et al. Gastroesophageal reflux disease prevalence in the city of Sivas. Turk J Gastroenterol 2013;24:303-10. 7. Bor S, Vardar R, Vardar E, Takmaz S, Mungan ZA. Endoscopic findings of gastroesophageal reflux disease in Turkey: Multicenter prospective study (GORHEN). Gastroenterology 2008;134:4(Suppl 1);A-600. 8. Bor S, Kitapcioglu G, Kasap E. Prevalence of gastroesophageal reflux disease in a country with a high occurrence of Helicobacter pylori. World J Gastroenterol 2017;23:525-32. 9. Liu HF, Zhang JG, Li J, Chen XG, Wang WA. Improvement of clinical parameters in patients with gastroesophageal reflux disease after radiofrequency energy delivery. World J Gastroenterol 2011;17:4429-33. 10. Perry KA, Banerjee A, Melvin WS. Radiofrequency energy delivery to the lower esophageal sphincter reduces esophageal acid exposure and improves GERD symptoms:a systematic review and metaanalysis. Surg Laparosc Endosc Percutan Tech 2012;22:283-8. 11. Corley DA, Katz P, Wo JM, et al. Improvement of gastroesophageal reflux symptoms after radiofrequency energy: a randomized, sham-controlled trial. Gastroenterology 2003;125:668-76. 12. Reymunde A, Santiago N. Long-term results of radiofrequency energy delivery for the treatment of GERD: Sustained improvements in symptoms, quality of life, and drug use at 4-year follow-up. Gastrointest Endosc 2007;65:361-6. 13. Dughera L, Navino M, Cassolino P, et al. Long-term results of radiofrequency energy delivery for the treatment of GERD: Results of a prospective 48-month study. Diagn Ther Endosc 2011;507157. 14. Noar M, Squires P, Noar E, Lee M. Long-term maintenance effect of radiofrequency energy delivery for refractory GERD: a decade later. Surg Endosc 2014;28:2323-33.