Department of Gastroenterology, Medical Faculty of Bezmi Alem University, Istanbul, Turkey.
Dig Endosc. 2014 Jan;26(1):37-42. doi: 10.1111/den.12081. Epub 2013 Apr 7.
The SRS(TM) Endoscopic Stapling System (Medigus Ltd, Omer, Israel) 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).
Of 27 participants, 11 underwent SRS and 16 LARS. Symptoms were assessed using Velanovich 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. Chi-squared and Mann-Whitney-U-tests were used for statistical analysis.
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 SRSand 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.
The short-term results of SRS are promising. The forthcoming new-generation devices and increasing experience may further improve efficacy and decrease untoward effects.
SRS（TM）内镜吻合系统（Medigus Ltd，Omer，以色列）是一种治疗胃食管反流病（GERD）的新方法。本研究评估了 SRS 与腹腔镜抗反流手术（LARS）相比的安全性和疗效。
27 名参与者中，11 名接受了 SRS，16 名接受了 LARS。使用 Velanovich 胃食管反流病健康相关生活质量（GERD-HRQL）评分评估症状。比较两组的手术时间、GERD-HRQL 评分改善情况和术后过程。使用卡方和曼-惠特尼 U 检验进行统计学分析。
16 名（59.3%）男性和 11 名（40.7%）女性患者，平均年龄为 39.6（范围：24-60）岁，平均体重指数为 26.2kg/m²。两组在统计学上相似。SRS 组观察到食管穿孔，经内镜下夹闭完全恢复。SRS 和 LARS 的手术时间分别为 89 和 47 分钟（P<0.05）。SRS 的平均出院时间长于 LARS（3 天比 1.2 天，P<0.05）。然而，在排除 SRS 组一名住院时间长的复杂患者后，这种差异消失了。在 6 个月的平均随访期间，SRS 组质子泵抑制剂的使用明显更高（P>0.05）。LARS 和 SRS 组的患者分别有 87%和 64%的患者（P>0.05）的 GERD-HRQL 评分从 29.3 分降至 4.1 分和从 24.8 分降至 8.9 分（P=0.016）。
SRS 的短期结果很有希望。新一代设备和不断增加的经验可能会进一步提高疗效并减少不良影响。
