Perry Kyle A, Banerjee Ambar, Melvin William Scott
Center for Minimally Invasive Surgery, Division of General and Gastrointestinal Surgery, The Ohio State University, Columbus, OH 43310, USA.
Surg Laparosc Endosc Percutan Tech. 2012 Aug;22(4):283-8. doi: 10.1097/SLE.0b013e3182582e92.
Studies of endoscopic application of radiofrequency energy to the lower esophageal sphincter for gastroesophageal reflux control have produced conflicting reports of its effectiveness. This study aimed to conduct a meta-analysis of randomized controlled trials and cohort studies to assess the impact of this treatment.
Twenty studies were included. Outcomes analyzed included gastroesophageal reflux disease (GERD) symptom assessment, quality of life, esophageal pH, and esophageal manometry.
A total of 1441 patients from 18 studies were included. Radiofrequency treatment improved heartburn scores (P=0.001), and produced improvements in quality of life as measured by GERD-health-related quality-of-life scale (P=0.001) and quality of life in reflux and dyspepsia score (P=0.001). Esophageal acid exposure decreased from a preprocedure Johnson-DeMeester score of 44.4 to 28.5 (P=0.007).
Radiofrequency ablation of the lower esophageal sphincter produces significant improvement in reflux symptoms and may represent an alternative to medical treatment and surgical fundoplication in select patients.
关于将射频能量内镜应用于食管下括约肌以控制胃食管反流的研究，其有效性报告相互矛盾。本研究旨在对随机对照试验和队列研究进行荟萃分析，以评估该治疗的影响。
纳入20项研究。分析的结局包括胃食管反流病（GERD）症状评估、生活质量、食管pH值和食管测压。
18项研究共纳入1441例患者。射频治疗改善了烧心评分（P = 0.001），并通过GERD健康相关生活质量量表（P = 0.001）和反流与消化不良生活质量评分（P = 0.001）测量，使生活质量得到改善。食管酸暴露从术前的约翰逊 - 德米斯特评分为44.4降至28.5（P = 0.007）。
食管下括约肌射频消融术可显著改善反流症状，对于部分患者可能是药物治疗和手术胃底折叠术的替代方法。
