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From: trigonometry1972 on 13 Sep 2007 08:07
Gastrointest Endosc. 2007 Mar;65(3):367-72.

Comment in:
Gastrointest Endosc. 2007 Mar;65(3):373-4.
Gastrointest Endosc. 2007 Mar;65(3):375-6.

Sustained improvement in symptoms of GERD and antisecretory drug use:
4-year follow-up of the Stretta procedure.

Noar MD, Lotfi-Emran S.

Heartburn and Reflux Study Center, Endoscopic Microsurgery Associates,
7402 York Road, Towson, MD 21204, USA.

BACKGROUND:
Approximately 20% of patients with GERD do not respond to medical
therapy. The Stretta radiofrequency antireflux procedure represents an
alternative to failed drug therapy for GERD. OBJECTIVE: The aim of
this study wasto assess symptom and medication changes after the
Stretta procedure during a4-year follow-up period.

DESIGN:
Prospective case series on intent-to-treat
basis. SETTING: Community practice. PATIENTS: Patients with GERD with
persistent
symptoms despite twice-daily proton pump inhibitor (PPI) medications.
INTERVENTIONS: The Stretta procedure was performed in drug-refractory
patients with GERD diagnosed by the presence of endoscopically
evidenced esophagitis or abnormal esophageal pH testing. Symptom
assessment was performed with a validated health-related quality-of-
life questionnaire (with and without medication) atbaseline and 6, 12,
24, 36, and 48 months after treatment. Complications of the procedure
and medication usage were analyzed.

MAIN OUTCOME MEASUREMENTS:
Significant changes in symptom scores, GERD quality-of-life
parameters, and
medication usage on the basis of clinical outcomes. RESULTS: We report
on a series of 109 consecutive patients treated with the Stretta
procedure who have reached 4-year follow-up. Complete long-term follow-
up assessment was available in matched data for 109 patients at 12
months, 108 patients at 24 months, 102 patients at 36 months, and 96
patients at 48 months. A second procedure was performed in 13
patients. Heartburn scores decreased from 3.6 to 1.18 (P < .001),
total heartburn score (GERD health-related quality-of-life
questionnaire)decreased from 27.8 to 7.1 (P < .001), and patient
satisfaction improved from 1.4 to 3.8 (P < .001) (see ). Medication
usage decreased significantly from 100% of patients on twice-daily PPI
therapy at baseline to 75% of patients showing elimination of
medications or only as-needed use of antacids/over-the-counter PPIs at
48 months (P < 0.005). There were no serious complications of the
procedure.

LIMITATIONS:
This is an uncontrolled, nonrandomized case series in
consecutive patients that does not include long-term pH or motility
studies.

CONCLUSIONS:
This study in drug-refractory patients with GERD found the Stretta
procedure to be a safe, effective, and durable treatment that produced
significant improvements in heartburn and quality of life and
decreased
medication usage during a 4-year period of follow-up.

From: Howard McCollister on 13 Sep 2007 08:15

<trigonometry1972(a)gmail.com> wrote in message
news:1189685259.234056.103540(a)o80g2000hse.googlegroups.com...
> Gastrointest Endosc. 2007 Mar;65(3):367-72.


>
> CONCLUSIONS:
> This study in drug-refractory patients with GERD found the Stretta
> procedure to be a safe, effective, and durable treatment that produced
> significant improvements in heartburn and quality of life and
> decreased
> medication usage during a 4-year period of follow-up.
>

The Stretta procedure is no longer available - Curon Medical went out of
business.

HMc



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