• Zahid Mahmood, Patrick J Byrne, Barry P McMahon, Edward M Murphy, Qamrul Arfin, Narayanasamy Ravi, Donald G Weir, and John V Reynolds.
• Department of Surgery & Medicine, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland.
• Am. J. Gastroenterol. 2006 Mar 1; 101 (3): 431-6.

BackgroundTransesophageal endoscopic plication (TEP) is a novel endotherapeutic approach in the management of gastroesophageal reflux disease (GERD). This non-randomized prospective study compares TEP with laparoscopic Nissen fundoplication (LNF).MethodsTwenty-four consecutive patients treated with LNF, and 27 managed by TEP were studied. Symptom severity scores, endoscopy, 24 h esophageal pH and esophageal manometry and quality-of-life assessments were obtained pre- and posttreatment.ResultsIn the LNF group the mean age was 36 yr (17-68) compared with 39 yr (22-62) in the TEP group. Symptom scoring, acid regurgitation score, reduction in the requirements of proton pump inhibitors (PPIs), and quality of life remained significantly improved in both groups at a median of 1 yr [10-18 months] follow-up post procedure. However, the improvement was significantly better in symptom score (p= 0.0383) and the control of acid reflux in the LNF group (p= 0.0007). Post-procedure dysphagia was more common in the LNF group.ConclusionBoth 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 LNF. TEP, like LNF, is a safe and effective method of management of symptomatic GERD but further developments are necessary to ensure control of esophageal acid reflux.

24 keywords...

hide…