Long-Term Results of Radiofrequency Energy Delivery for the Treatment of GERD: Results of a Prospective 48-Month Study

Abstract

Since 2000, radiofrequency (RF) energy treatment has been increasingly offered as an alternative option to invasive surgical procedures for selected patients with gastroesophageal reflux disease (GERD). Out of 69 patients treated since June 2002 to December 2007 with the Stretta procedure, 56 of them reached by the end of 2010 a 48-month followup. RF treatment significantly improved heartburn scores, GERD-specific quality of life scores, and general quality of life scores at 24 and 48 months in 52 out of 56 patients (92,8%). At each control time both mean heartburn and GERD HRQL scores decreased (P = 0.001 and P = 0.003, resp.) and both mental SF-36 and physical SF-36 ameliorated (P = 0.001 and 0.05, resp.). At 48 months, 41 out of 56 patients (72,3%) were completely off PPIs. Morbidity was minimal, with only one relevant but transient complication. According to other literature data, this study shows that RF delivery to LES is safe and durably improves symptoms and quality of life in well-selected GERD patients.

Stretta Radiofrequency Treatment for GERD: A Safe and Effective Modality

“…At 48 months, 41 out of 56 patients (72.3%) were completely off PPIs ( Figure 5). Morbidity was minimal, except for one patient who developed transient gastroparesis [25].…”

“…Recently, Dughera reported on 56 patients who also reached 48 months of followup and had significantly improved heartburn scores, GERD-specific QoL scores, and general QoL scores at 24 and 48 months in 52 (93%) of patients. At 48 months, 41 patients (72%) were completely off PPIs [25]. At 8 years, 60% of available patients were still not using PPIs [30].…”

“…Dughera and colleagues found that only 1 out of 56 patients treated with Stretta developed gastroparesis, and this resolved in 8 weeks [25]. Noar and colleagues showed that Stretta improved gastroparesis in a study where they followed a cohort of 31 patients with gastroparesis 6 months after Stretta and found that 74% of patients have normalization of gastric emptying [31].…”

Quality of life in patients with gastroesophageal reflux disease following pharmacotherapeutic, endoscopic, and surgical treatment

“…These techniques include the Stretta procedure (Stretta System Mederi Therapeutics, Inc., Greenwich, CT), plication of the gastroesophageal junction (NDO Plicator, NDO Surgical, Inc., Mansfiled, MA; EndocCinch, CR Bard, Inc., Murray Hill, NJ), and injection of biopolymers into the gastroesophageal junction (Enteryx, Boston Scientific Corporation, Natick, MA; Gatekeeper, Medtronic Foundation, Minneapolis, MN, Plexiglas). Several studies have shown a significant improvement in HRQOL of patients treated with Stretta procedure [50][51][52]. In one recent study of 56 patients subjected to Stretta procedure (including 64.2% of males) and followed-up for 48 months [51], the quality of life was determined with the help of the SF-36 generic questionnaire and GERD-specific GERD-HRQL instrument prior to the procedure, and 24 and 48 months thereafter.…”

“…Several studies have shown a significant improvement in HRQOL of patients treated with Stretta procedure [50][51][52]. In one recent study of 56 patients subjected to Stretta procedure (including 64.2% of males) and followed-up for 48 months [51], the quality of life was determined with the help of the SF-36 generic questionnaire and GERD-specific GERD-HRQL instrument prior to the procedure, and 24 and 48 months thereafter. The severity of heartburn was determined using a Likerttype scale.…”