Transesophageal endoscopic plication is a novel endotherapeutic approach in the management of gastroesophageal reflux disease (GERD).
Professor John Reynolds and colleagues from Ireland conducted a non-randomized prospective study comparing the 2 techniques.
The investigative team treated 24 consecutive patients with Nissen fundoplication.
A further 27 patients were managed by transesophageal endoscopic plication .
Symptom severity scores, endoscopy, 24 hour esophageal pH and esophageal manometry and quality-of-life assessments were obtained pre- and posttreatment.
In the Nissen fundoplication group the mean age was 36 years compared with 39 years in the transesophageal endoscopic plication group.
Symptom scoring, acid regurgitation score, reduction in the requirements of proton pump inhibitors (PPIs) improved in both groups at a median of 1 year follow-up.
The team noted that quality of life remained significantly improved in both groups at a median of 1 year follow-up post procedure.
| Post-procedure dyspagia was more common in the Nissen fundoplication group|
|American Journal of Gastroenterology|
However, the improvement was significantly better in symptom score and the control of acid reflux in the Nissen fundoplication group.
The investigators found that post-procedure dyspagia was more common in the Nissen fundoplication group.
Professor Reynolds team commented, “Both techniques improved symptom score, acid regurgitation, quality of life, and reduced the requirements for PPIs.”
“The control of heartburn and acid reflux was better for Nissen fundoplication.”
“Transesophageal endoscopic plication, like Nissen fundoplication, is a safe and effective method of management of symptomatic GERD but further developments are necessary to ensure control of esophageal acid reflux.”