Introduction: The Stretta procedure is an endoluminal radiofrequency energy delivery system for the treatment of gastroesophageal reflux disease (GERD). This is a single center experience in the treatment of 40 patients, evaluated after 1 year. Methods: From May 2001 to November 2004, 86 patients underwent Stretta, we report here the results of the first 40 patients after 1 year after the procedure. All patients were responsive to daily PPI and had chronic GERD (2-30 yrs). Esophageal motility, endoscopy, and ambulatory 24-hour pH studies were performed. A guidewire was used to introduce the Stretta catheter. Thermal lesions were created in the gastroesophageal junction, while cooling the mucosa, from 1 cm above to 0.5 cm below the z-line and in the region of the cardia. We evaluated baseline and follow-up medication use, satisfaction, 24 hour pH metry, manometry and endoscopy. Results: Endoscopy demonstrated no hiatal hernia > 2.5 cm and no esophagitis at the time procedure. Sedation was midazolam (mean 5 mg) and propofol (mean 660 mg). Immediate post-treatment endoscopy revealed small punctate lesions in the LES and cardia. There were no procedure related complications, but 66% of the patients experienced mild epigastric discomfort < 24-hrs. From a total of 40 patients 7 (16%) refused follow-up examinations. Of the remaining patients 60% experienced the effect as very effective, 22% partially effective and 18% not effective. Baseline mean LES pressure was 10 mm Hg before and after 1 year, with persistent normal esophageal peristalsis. Baseline mean total reflux time was 16% before and 8.3% after 1 year (p<0.001). There were no significant changes of the heartburn (1.0 vs. 2.0) and satisfaction scores (3.0 vs. 4.0) but a significant change in improvement of the medication score (7.0 vs 1.5). Esophagitis was not detectable in 72%, improved in 19% and impaired in 9%. Conclusion: Our one-year experience with the Stretta-procedure confirms it to be a well-tolerated intervention with significant therapeutic effects in the treatment of GERD without impairment of motility parameters. Introduction: The Stretta procedure is an endoluminal radiofrequency energy delivery system for the treatment of gastroesophageal reflux disease (GERD). This is a single center experience in the treatment of 40 patients, evaluated after 1 year. Methods: From May 2001 to November 2004, 86 patients underwent Stretta, we report here the results of the first 40 patients after 1 year after the procedure. All patients were responsive to daily PPI and had chronic GERD (2-30 yrs). Esophageal motility, endoscopy, and ambulatory 24-hour pH studies were performed. A guidewire was used to introduce the Stretta catheter. Thermal lesions were created in the gastroesophageal junction, while cooling the mucosa, from 1 cm above to 0.5 cm below the z-line and in the region of the cardia. We evaluated baseline and follow-up medication use, satisfaction, 24 hour pH metry, manometry and endoscopy. Results: Endoscopy demonstrated no hiatal hernia > 2.5 cm and no esophagitis at the time procedure. Sedation was midazolam (mean 5 mg) and propofol (mean 660 mg). Immediate post-treatment endoscopy revealed small punctate lesions in the LES and cardia. There were no procedure related complications, but 66% of the patients experienced mild epigastric discomfort < 24-hrs. From a total of 40 patients 7 (16%) refused follow-up examinations. Of the remaining patients 60% experienced the effect as very effective, 22% partially effective and 18% not effective. Baseline mean LES pressure was 10 mm Hg before and after 1 year, with persistent normal esophageal peristalsis. Baseline mean total reflux time was 16% before and 8.3% after 1 year (p<0.001). There were no significant changes of the heartburn (1.0 vs. 2.0) and satisfaction scores (3.0 vs. 4.0) but a significant change in improvement of the medication score (7.0 vs 1.5). Esophagitis was not detectable in 72%, improved in 19% and impaired in 9%. Conclusion: Our one-year experience with the Stretta-procedure confirms it to be a well-tolerated intervention with significant therapeutic effects in the treatment of GERD without impairment of motility parameters.