Three-Year Results of a Multicenter Prospective Study of Transoral Incisionless Fundoplication

Abstract

The clinical outcomes at 3 years following TIF, patient satisfaction, healing of erosive esophagitis, and cessation of PPI medication support long-term safety and durability of the TIF procedure for those with initial treatment success. Although complete normalization of pH studies occurred in a minority of patients, successful cases showed long-term durability.

Long-term efficacy of transoral incisionless fundoplication with Esophyx (Tif 2.0) and factors affecting outcomes in GERD patients followed for up to 6 years: a prospective single-center study

“…Figures up to 3 years on symptom outcomes are similar to those recently reported in the only three-year follow-up study on TIF so far published [17].…”

“…Our results are similar to most of the 11 follow-up studies so far published: eight reported good symptomatic and objective outcomes, in from 75 to 82 % 6 months after TIF [7-10, 12-14, 17, 18], 76-85 % at 12 months [7-9, 14, 15, 17], and 75-93 % at 24 months [8,14,17]. Only two studies, including the present one, reported three-year outcomes regarding discontinuation of daily PPI, with rates of 74 % [17] and 75.8 % in our series.…”

“…Only two studies, including the present one, reported three-year outcomes regarding discontinuation of daily PPI, with rates of 74 % [17] and 75.8 % in our series.…”

“…In other series, surgical revision after TIF failure was reported in from 10.6 to 18.0 % of cases [17,35,36]. Worse outcomes after TIF were reported in two studies, which found, respectively, 66.7 and 68 % of nonresponders after 12 months in a small series of patients and with a short follow-up [38,39].…”

“…The procedure was designed to create serosa-toserosa plications which include the muscle layers and construct valves 3-5 cm long, taking in 200-300°of the circumference, deploying multiple non-absorbable polypropylene fasteners through the two layers (esophagus and stomach) in a circumferential pattern around the gastroesophageal junction [4][5][6]. Previous studies reported the persistence of the newly created valve at 6 months and for up to 36 years, with good functional outcomes, judging from 24-h pH-and/or impedance monitoring [7][8][9][10][11][12][13][14][15][16][17][18]. However, like all new procedures introduced in clinical practice, despite favorable short-term outcomes, questions still arise about the long-term efficacy of the technique in controlling symptoms, and the duration of the newly created valve.…”