Abstract
Background Transoral incisionless fundoplication with EsophyX is reported to be effective in
patients with gastroesophageal reflux disease in short-medium term follow-up.
Aim To examine clinical outcomes up to 10 years.
Methods In total, 51 procedures were performed in 50 patients. All entered a yearly clinical
follow-up schedule including gastroesophageal reflux disease health-related quality-of-life
questionnaires, heartburn and regurgitation scores, and daily proton pump inhibitor
consumption.
Results The procedure was successfully performed in 49/50 patients. Severe complications
occurred in 2/51 procedures. The remaining 49 patients were re-evaluated at 2 and
3 years, 41 after 5 years, 30 after 7 years, and 14 after 10 years. Eight patients
were lost to follow-up between 3 and 5 years. Seven patients who were unresponsive
to endoscopic fundoplication underwent surgical fundoplication. The mean scores at
2 years were significantly lower than before the procedure and did not change substantially
during the follow-up. The rates of patients who had stopped or halved antisecretive
therapy 2, 3, 5, 7, and 10 years after the procedure were 86.7 %, 84.4 %, 73.5 %,
83.3 %, and 91.7 %, respectively.
Conclusions Transoral incisionless fundoplication with EsophyX is an effective therapeutic option
for symptomatic gastroesophageal reflux disease patients, with Hill grades I – II
or hiatal hernia < 2 cm, who refuse life-long medical therapy or surgery.
