Long-term Outcome of Medical and Surgical Therapies for Gastroesophageal Reflux Disease

Spechler, Stuart J.; Lee, Edward; Ahnen, Dennis J.; Goyal, Raj K.; Hirano, Ikuo; Ramirez, Francisco C.; Raufman, Jean‐Pierre; Sampliner, Richard E.; Schnell, Thomas; Sontag, Stephen J.; Vlahčevič, Z. Reno; Young, Renée; Williford, William O.

doi:10.1001/jama.285.18.2331

Cited by 853 publications

(401 citation statements)

References 48 publications

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“…Complete control of reflux in this population of patients could only be achieved through antireflux surgery, which has been shown more effective than PPIs in terms of patient satisfaction and clinical outcome because of its ability to reconstruct the biomechanics and physiology of the esophagogastric junction [11-14, 27, 31]. It is foreseeable that this population of patients with chronic GERD requiring long-term medical therapy would benefit from early surgery, which has been demonstrated in several randomized, controlled trials [15,30,32]. The absence of TIF-related adverse events supported long-term safety of TIF.…”

Section: Discussionmentioning

confidence: 99%

Two-year results of a feasibility study on antireflux transoral incisionless fundoplication using EsophyX

et al. 2009

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Background A feasibility study (n = 19) evaluated the safety and initial efficacy of transoral incisionless fundoplication (TIF) for the treatment of gastroesophageal disease (GERD). The results at 1 year (n = 17) indicated that TIF was safe and had a significant effect on reducing GERD symptoms, proton pump inhibitor (PPI) usage, acid exposure, and small hiatal hernia. This study was designed to evaluate the long-term safety and durability of TIF. Methods Fourteen patients (50% female; median age, 34 years) completed the 2-year follow-up assessment tests. Three patients were excluded from the study after 1 year because two of them underwent retreatment and one was lost to follow-up. Results At 2 years, no adverse events related to TIF were reported. A C50% improvement in GERD-HRQL scores compared with those at baseline on PPIs was sustained by 64% of patients. TIF was effective in eliminating heartburn in 93% of patients and daily PPI therapy in 71% of patients. Significantly (p \ 0.05) more patients were able to consume reflux-causing foods and maintain lifestyle activities without GERD symptoms compared with baseline on PPIs. Fundoplications were durable and maintained their geometric dimensions. TIF was effective in eliminating hiatal hernia in 60% of patients and esophagitis in 55% of patients. Global assessment of all outcomes in each patient revealed that 79% of patients experienced complete cure (29%) or remission (50%) of GERD at 2 years after TIF. Conclusion The results at 2 years supported the longterm safety and durability of TIF and its sustained effect on the elimination of heartburn, esophagitis, B2 cm hiatal hernia, and daily dependence on PPIs.

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Section: Discussionmentioning

confidence: 99%

Two-year results of a feasibility study on antireflux transoral incisionless fundoplication using EsophyX

et al. 2009

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“…Another 19% were able to reduce the frequency of their medicines. These success rates are lower than those found with the Nissen procedure, which resolved GERD in 80% to 90% of cases (5,6). The hope is that future advances in endoscopic techniques will allow for less-invasive alternatives for the treatment of persistent and refractory GERD.…”

Section: Discussionmentioning

confidence: 83%

Outcomes of Endoluminal Gastric Plication for the Treatment of Gastroesophageal Reflux Disease

DeMarco

Anderson²

2003

Baylor University Medical Center Proceedings

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“…1 Endoscopic eradication therapy with radiofrequency ablation significantly reduces the frequency of progression to cancer for patients with high-grade dysplasia. 2 …”

Section: Barrett's Oesophagus and Cancermentioning

confidence: 99%

Oesophageal cancer: diagnosis and management

Kulendran

Siddiqui

et al. 2016

Trends Urol & Men's Health

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Oesophageal cancer is the ninth most common cancer in the UK. With 8500 cases diagnosed annually, the UK has the highest rates of oesophageal cancer in Western Europe. Adenocarcinoma now accounts for 60–75% of all oesophageal cancers in the UK and is three to four times more common in men. Despite advances in diagnosis and treatment, five‐year survival rates for all patients diagnosed with oesophageal cancer ranges from 15–20%. In this article the authors discuss current diagnosis and management.

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Long-term Outcome of Medical and Surgical Therapies for Gastroesophageal Reflux Disease

Abstract: This study suggests that antireflux surgery should not be advised with the expectation that patients with GERD will no longer need to take antisecretory medications or that the procedure will prevent esophageal cancer among those with GERD and Barrett esophagus.

Cited by 853 publications

References 48 publications

Two-year results of a feasibility study on antireflux transoral incisionless fundoplication using EsophyX

Two-year results of a feasibility study on antireflux transoral incisionless fundoplication using EsophyX

Outcomes of Endoluminal Gastric Plication for the Treatment of Gastroesophageal Reflux Disease

Oesophageal cancer: diagnosis and management

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