ORIGINAL ARTICLES   

Minerva Chirurgica 2014 August;69(4):217-23

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

Five-year follow-up of a prospective study comparing laparoscopic Nissen fundoplication with Stretta radiofrequency for gastroesophageal reflux disease

Liang W. T. ¹, Wu J. N. ², Wang F. ², Hu Z. W. ², Wang Z. G. ^{1, 2}, Ji T. ², Zhan X. L. ², Zhang C. ¹ ✉

¹ Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Xicheng District, Beijing, P. R. China; ² Center for GERD, The Second Artillery General Hospital of Chinese People’s Liberation Army, Beijing, P. R. China

AIM: Laparoscopic Nissen fundoplication (LNF) and Stretta radiofrequency (RF) are used as main alternative strategies to manage medication-refractory GERD. This study was therefore prospectively evaluated outcomes of patients with refractory GERD 5 years after LNF or Stretta RF.
METHODS: A total of 215 consecutive patients with refractory GERD underwent LNF (N.=102) and Stretta RF (N.=113) in our department between 2007 and 2008. They were followed-up for 5 years, during which the outcome measures including symptom scores of regurgitation, heartburn, chest pain, belching, hiccup, cough and asthma as well as the proton pump inhibitor (PPI) use and complications.
RESULTS: Of the 215 patients, 179 patients following LNF (N.=87) or Stretta RF (N.=92) completed the designated 5-year follow-up and were included in the final analysis. At the end of 5-year follow-up, the post-treatment scores were statistically lower as compared with the pre-treatment scores in both groups, while the symptom improvements after Stretta were significantly lower than that after LNF (p < 0.05). Besides, 81 (91%) patients achieved complete PPI therapy independence after LNF, comparing with 47 (51.1%) after Stretta RF (P<0.05). No significant differences in post-treatment complications were observed except for the abdominal distention.
CONCLUSION: Even though laparoscopic Nissen fundoplication and Stretta RF are capable of controlling GERD symptoms effectively and safely in selected patients, LNF could improve more in symptoms and PPI elimination.