Authors: Stavros A Antoniou Oliver O Koch Adolf Kaindlstorfer Kai U Asche Johannes Berger Frank A Granderath Rudolph Pointner
Publish Date: 2011/11/01
Volume: 26, Issue: 4, Pages: 1063-1068
Abstract
Endoscopic antireflux techniques have emerged as alternative therapies for gastroesophageal reflux disease GERD Endoscopic plication receives continuing interest as an effective and safe procedure This treatment option has not been the subject of comparison with wellestablished operative therapies to date The present study aimed at comparatively evaluating the effectiveness of endoscopic plication and laparoscopic fundoplication in terms of quality of life and symptom controlBetween October 2006 and April 2010 60 patients with documented GERD were randomly assigned to undergo either endoscopic plication or laparoscopic fundoplication Qualityoflife scores and symptom grading were recorded before treatment and at 3 and 12month followup Outcomes were compared with the statistical significance set at a p value of 005Twentynine patients from the endoscopic group and 27 patients from the operative group were available at followup Qualityoflife scores showed a substantial and similar increase for both groups after treatment Symptoms of heartburn p 002 regurgitation p 0004 and asthma p = 003 were significantly improved in the endoscopic group whereas laparoscopic fundoplication was more effective in controlling symptoms of heartburn p 001 and regurgitation p 005 compared to the endoscopic procedureEndoscopic plication and laparoscopic fundoplication resulted in significant symptom improvement with similar qualityoflife scores in a selected patient population with GERD whereas operative treatment was more effective in the relief of heartburn and regurgitation at the expense of higher shortterm dysphagia rates
Keywords: