Endoscopy 2019; 51(04): S193
DOI: 10.1055/s-0039-1681742
ESGE Days 2019 ePoster podium presentations
Saturday, April 6, 2019 14:00 – 14:30: GERD ePoster Podium 4
Georg Thieme Verlag KG Stuttgart · New York

ULTRASOUND-GUIDED TRANSORAL FUNDOPLICATION FOR THE TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE: RESULTS UP TO 24 MONTHS FROM A SINGLE-CENTER PROSPECTIVE STUDY

PA Testoni
1   IRCCS San Raffaele Scientific Institute – Vita-Salute San Raffaele University, Milan, Italy
,
G Mazzoleni
1   IRCCS San Raffaele Scientific Institute – Vita-Salute San Raffaele University, Milan, Italy
,
G Distefano
1   IRCCS San Raffaele Scientific Institute – Vita-Salute San Raffaele University, Milan, Italy
,
SGG Testoni
1   IRCCS San Raffaele Scientific Institute – Vita-Salute San Raffaele University, Milan, Italy
,
M Antonelli
1   IRCCS San Raffaele Scientific Institute – Vita-Salute San Raffaele University, Milan, Italy
,
L Fanti
1   IRCCS San Raffaele Scientific Institute – Vita-Salute San Raffaele University, Milan, Italy
,
S Passaretti
1   IRCCS San Raffaele Scientific Institute – Vita-Salute San Raffaele University, Milan, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Transoral incisionless fundoplication (TIF) with the MUSE system is a new ultrasound-guided intervention for the treatment of gastroesophageal reflux disease (GERD). Aim of this study was to assess the safety of TIF with MUSE and its effects on clinical, pathophysiological and endoscopic results.

Methods:

TAF with MUSE was performed in a series of consecutive patients (pts) with symptomatic GERD, in a single-center study. All pts underwent GERD-Related Quality of Life (GERD-HRQL) and Reflux Symptom Index (RSI) questionnaires, upper gastrointestinal endoscopy, 24h esophageal pH-impedance recording and high-resolution esophageal manometry (HRM) before, 6 months and 12 months after TIF (HRM only before and 6 months after). Symptoms questionnaires and proton pump inhibitors (PPIs) consumption were also investigated at 24 months. Data were compared to baseline using Fisher test for frequencies and Wilcoxon test for nonparametric data.

Results:

Thirty-seven pts underwent TIF. In two cases it wasn't possible to perform esophageal intubation with the endostapler and perforation occurred in two cases. Clinical follow-up was completed in 29, 23 and 16 pts at 6, 12 and 24 months, respectively. Compared to baseline, median symptoms scores and PPIs consumption were significantly improved after TIF. Endoscopic follow-up was completed in 28 and 22 pts at 6 and 12 months, with 5 and 4 pts who had esophagitis, respectively. Pathophysiological follow-up was completed in 19 and 15 pts at 6 and 12 months, respectively. Compared to baseline, 6 months after TIF there were a significantly lower number of acid, proximal and total refluxes, detected by esophageal impedance and a significantly increase of lower esophageal sphincter length, esophagogastric junction contractile integral (EGJ-CI) and of peristaltic waves rate, detected by HRM.

Conclusions:

Our data showed TIF by MUSE safe and effective, allowing a significant improvement of symptoms scores and a significant reduction of PPIs consumption and refluxes number, detected by esophageal impedance.