The Outcome of Endoscopic Radiofrequency Anti-Reflux Therapy (STRETTA) for Gastroesophageal Reflux Disease in Patients with Previous Gastric Surgery: A Prospective Cohort Study
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Background/Aims: STRETTA improves the quality of life and reduces the need for anti-reflux medication in select patients,especially those with uncomplicated gastroesophageal reflux disease (GERD). We aimed to review the outcomes of STRETTA inpatients with medically refractory GERD, who had undergone previous gastric surgery. Methods: This was a review of a prospective database in a British center. Since 2016, all GERD patients who underwent STRETTAand had a history of previous gastric surgery were studied (n=11). Anti-reflux medication pre- and post-STRETTA was evaluated. The outcomes were assessed objectively by the change in anti-reflux medication and subjectively through a pre- and post-procedureGERD-health-related quality of life (HRQL) questionnaire. Results: The median length of follow-up was 23 months. Nine patients demonstrated improved GERD-HRQL scoresfollowing STRETTA (82%). Of the 7 patients who underwent fundoplication, all reported improved symptoms, with 3 patientsdiscontinuing the medication and 3 patients on a reduced dose of proton pump inhibitor. Four patients underwent surgery otherthan fundoplication, of which 2 reported improvement and discontinued the proton pump inhibitor. Two patients reported noimprovement. Conclusions: This study demonstrates that STRETTA is successful in reducing refractory GERD in patients with previous gastricsurgery. The outcomes were comparable to published outcomes in patients with uncomplicated GERD with no previous history ofgastric surgery.
Abstract
Background/Aims: STRETTA improves the quality of life and reduces the need for anti-reflux medication in select patients,especially those with uncomplicated gastroesophageal reflux disease (GERD). We aimed to review the outcomes of STRETTA inpatients with medically refractory GERD, who had undergone previous gastric surgery. Methods: This was a review of a prospective database in a British center. Since 2016, all GERD patients who underwent STRETTAand had a history of previous gastric surgery were studied (n=11). Anti-reflux medication pre- and post-STRETTA was evaluated. The outcomes were assessed objectively by the change in anti-reflux medication and subjectively through a pre- and post-procedureGERD-health-related quality of life (HRQL) questionnaire. Results: The median length of follow-up was 23 months. Nine patients demonstrated improved GERD-HRQL scoresfollowing STRETTA (82%). Of the 7 patients who underwent fundoplication, all reported improved symptoms, with 3 patientsdiscontinuing the medication and 3 patients on a reduced dose of proton pump inhibitor. Four patients underwent surgery otherthan fundoplication, of which 2 reported improvement and discontinued the proton pump inhibitor. Two patients reported noimprovement. Conclusions: This study demonstrates that STRETTA is successful in reducing refractory GERD in patients with previous gastricsurgery. The outcomes were comparable to published outcomes in patients with uncomplicated GERD with no previous history ofgastric surgery.
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