GERD Procedures Ditch Scalpels

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Updated: 1/17/2013 7:20 pm

Jan. 20, 2009 -- Researchers report promising results for new procedures to treat GERD without making any surgical incisions in the skin.

Both treatments are endoscopic, meaning that doctors perform the procedures via a tiny tube passed through the mouth and guided to the junction of the stomach and the esophagus. That's where the lower esophageal sphincter is located; the major cause of GERD is the lower esophageal sphincter not working properly.

GERD patients that don't respond to drug treatment are sometimes referred for laparoscopic surgery, which requires the surgeon to make small incisions in the abdomen.

Instead of laparoscopic surgery, doctors at Emory University and the Medical College of Georgia performed endoscopic procedures on 126 patients with persistent GERD.

Some of those patients got a procedure called full-thickness plication (FTP), in which doctors stitched a tissue valve at the lower esophageal sphincter. Other patients got endoscopic radiofrequency treatment to tone the lower esophageal sphincter to make it work better.

After their procedure the patients were followed for six months, on average. During that time, patients in both groups cut back on their use of proton pump inhibitors (PPIs) to treat GERD and had a drop in voice problems related to GERD and less difficulty in swallowing.

The radiofrequency treatment group also had a drop in the percentage of patients with moderate to severe GERD.

"Our experience indicates that both procedures are effective, providing symptomatic relief and reduction in PPI use," Emory's Louis Jeansonne IV, MD, and colleagues write in the Archives of Surgery.

"Both procedures resulted in GERD symptom improvement and demonstrated an excellent safety profile," but the long-term results aren't clear yet and there was no comparison with sham treatment or laparoscopic surgery, notes Jon Gould, MD, of the surgery department at the University of Wisconsin Medical School.

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