Department of General Surgery, the Second Hospital of Hebei Medical University, 19 Jiuzhong Street, Shijiazhuang, 050000, China.
BMC Gastroenterol. 2020 May 27;20(1):162. doi: 10.1186/s12876-020-01310-2.
Outcomes of gastroesophageal reflux disease (GERD) using Toupet fundoplication (TF) and Stretta radiofrequency (SRF) have not been compared and this study was conducted to compare therapeutic efficacy of the two methods.
This retrospective study analyzed a total of 230 patients undergoing TF or SRF at our hospital. Baseline data, reflux symptoms, the DeMeester scores, lower esophageal sphincter (LES) pressure and adverse events were compared over 1 year period.
A total of 226 patients were included in the study. The time and frequency of reflux and percentage of reflux time before and 12 months after therapy were not significantly different. There were significantly interactions between the therapy method and follow-up time on the DeMeester score and LES pressure. Twelve months post therapy, the DeMeester score was significantly higher in SRF than in TF group, while the LES pressure was lower. At 12 months after therapy, multivariate Cox proportional regression analysis showed that reflux frequency, the DeMeester score and LES pressure were risk factors for poor prognosis in TF group, while reflux frequency and the DeMeester score, and LES pressure were risk factors for poor prognosis in SFR group.
Compared with TF, SFR can significantly improve the esophageal pH and pressure in GERD patients without increasing the risk of poor prognosis.
胃食管反流病（GERD）采用 Toupet 胃底折叠术（TF）和 Stretta 射频（SRF）的治疗效果尚未进行比较，本研究旨在比较这两种方法的治疗效果。
本回顾性研究分析了在我院行 TF 或 SRF 的 230 例患者。比较了 1 年内的基线数据、反流症状、DeMeester 评分、食管下括约肌（LES）压力和不良事件。
共有 226 例患者纳入研究。治疗前后反流时间和频率以及反流时间百分比均无显著差异。治疗方法和随访时间之间存在显著的交互作用，影响 DeMeester 评分和 LES 压力。治疗 12 个月后，SRF 组的 DeMeester 评分明显高于 TF 组，而 LES 压力则较低。治疗 12 个月后，多变量 Cox 比例风险回归分析显示，反流频率、DeMeester 评分和 LES 压力是 TF 组预后不良的危险因素，而反流频率、DeMeester 评分和 LES 压力是 SFR 组预后不良的危险因素。
与 TF 相比，SRF 可显著改善 GERD 患者的食管 pH 值和压力，而不会增加预后不良的风险。
