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Endoscopic stapling in comparison to laparoscopic fundoplication for the treatment of gastroesophageal reflux disease
Author(s) -
Danalioglu Ahmet,
Cipe Gokhan,
Toydemir Toygar,
Kocaman Orhan,
Ince Ali Tuzun,
Muslumanoglu Mahmut,
Senturk Hakan
Publication year - 2014
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12081
Subject(s) - medicine , gerd , reflux , perforation , gastroenterology , body mass index , surgery , disease , materials science , punching , metallurgy
Background The SRS TM E ndoscopic S tapling S ystem ( M edigus L td, O mer, I srael) is a novel method for the treatment of gastroesophageal reflux disease ( GERD ). The present study assessed the safety and efficacy of SRS compared with laparoscopic anti‐reflux surgery ( LARS ). Patients and Methods Of 27 participants, 11 underwent SRS and 16 LARS . Symptoms were assessed using V elanovich GERD –health‐related quality of life ( GERD‐HRQL ) scores. The groups were compared in reference to operation time, improvement in GERD‐HRQL scores, and postoperative course. C hi‐squared and M ann– W hitney‐ U ‐tests were used for statistical analysis. Results Of 16 (59.3%) male and 11 (40.7%) female patients, mean age was 39.6 (range: 24–60) years and mean body mass index was 26.2 kg/m 2 . Both groups were statistically similar. An esophageal perforation observed in the SRS group completely recovered after over‐the‐scope clipping. Procedure times for SRS and LARS were 89 and 47 min, respectively ( P < 0.05). Mean discharge time was longer for SRS than LARS (3 days vs 1.2 days, P < 0.05). However, this difference disappeared with the exclusion of a complicated patient with long hospitalization in the SRS group. During 6 months mean follow up, proton‐pump inhibitor use was insignificantly higher in the SRS group ( P > 0.05). Mean GERD‐HRQL scores dropped in 87% and in 64% of patients ( P > 0.05) from 29.3 to 4.1 and from 24.8 to 8.9 ( P = 0.016) in LARS and SRS groups, respectively. Conclusion The short‐term results of SRS are promising. The forthcoming new‐generation devices and increasing experience may further improve efficacy and decrease untoward effects.