Evolution and Outcome of Eight Patients Undergoing Treatment of Gastroesophageal Disease by Esophyx

Abstract

Background: Gastroesophageal reflux disease (GERD) is arguably the most common disease encountered by the gastroenterologist. It is mainly caused by defects in the lower esophageal sphincter (LES) that induces spontaneous transient LES relaxations (tLESRs). This is a chronic condition with typical and atypical, sometimes troublesome manifestations requiring long term treatment. Anti-reflux surgery is an alternative option. The TIF (transoral incisionless fundoplication) procedure by offering some advantages over surgery could be recommended for patients whose symptoms recur upon discontinuation of the medications. This study intended to assess the safety and efficacy of TIF for treating GERD. Methods: A prospective trial was conducted at Lebanese Hospital Geitaoui University Medical Center and Middle East Institute of Health in Lebanon, on 8 patients, age 28-55 years, with chronic GERD, symptoms (>5 years), undergoing EsophyX procedure and followed for 1 year after their procedure. Information concerning the patients was gathered using an international questionnaire (GERD-HRQL, Health Related Quality of Life questionnaire) filled by the treating physician. Results: When compared to scores before TIF and without medications, the GERD-HRQL scores were significantly reduced one year after the procedure. Regurgitation experienced was reduced to 62.5% compared to 75% while patients were off PPI. Symptoms free (GERD-HRQL score ≤ 12) achieving complete cessation of medications, were reported by 25% of patients. Overall 37.5% of patients were satisfied, 12.5% neutral, and 50% less satisfied with their results.