Endoscopy 2020; 52(S 01): S118
DOI: 10.1055/s-0040-1704364
ESGE Days 2020 oral presentations
Saturday, April 25, 2020 08:30 – 10:30 Esophageal High-tech: Newtreatment modalities for the esophagus Liffey Meeting Room 2
© Georg Thieme Verlag KG Stuttgart · New York

COMPARISON OF LONG-TERM OUTCOMES BETWEEN STRETTA AND ANTI-REFLUX ENDOSCOPIC SURGERY (ARES) IN REFRACTORY GERD PATIENTS

DS Noh
1   Cha Bundang Medical Center, Seoungnam, Korea, Republic of
,
JY Cho
1   Cha Bundang Medical Center, Seoungnam, Korea, Republic of
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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Aims Traditionally, the use of proton pump inhibitors (PPI) in gastroesophageal reflux disease (GERD) is well-known as a primary treatment. However, approximately 10 percent of patients failed to respond to PPI treatment. Recently, noble endoscopic techniques, such as anti-reflux endoscopic surgery (ARES) and Stretta, have been developed. The aim of this study is to compare the long term outcomes and efficacy between anti-reflux endoscopic surgery (ARES) and Stretta procedure.

Methods This study was conducted as a retrospective, single-center study in Cha Bundang Medical Center. From December 2015 to July 2019, a total of 208 patients has been diagnosed as refractory GERD. Total of 113 patients and 82 has performed ARES and Stretta procedures, respectively; however, 30 patients and 32 patients have been excluded due to follow-up loss or prior endoscopic or surgical procedures. Long clinical outcomes among the two groups were compared using the GERD symptom score (GERD-Q score), EndoFlip, 24 hr pH monitoring, and esophageal manometry.

Results The GERD-Q score and 24 hr pH monitoring were significantly improved in both groups. In Stretta group, the GERD-Q scores measured In Stretta group were 10.514 [9.618 to 11.409] prior to the procedure, 8.201 [7.392 to 9.009] after 3 months, and 7.727 [7.030 to 8.425] after 6 months. In the ARES group, the GERD-Q scores were 10.653 [10.015 to 11.292] prior to the procedure, 7.874 [7.297 to 8.451] after 3 months, and 7.414 [6.917 to 7.912] after 6 months. To compare the procedural outcomes in 3 months and 6 months, respectively, the delta ratio has been calculated. The delta ratio of GERD-Q score in 3 months and 6 months after the procedure were 1.914 [0.848 to 4.320] (p = 0.118), and 1.627 [0.631 to 4.196] (p = 0.314).

Conclusions Both ARES and Stretta are good alternative treatment options for refractory GERD patients rather than PPI therapy. However, there was no significant difference in treatment outcomes between the two group.