Nevins Edward John, Dixon James Edward, Viswanath Yirupaiahgari Krishnaiah Setty
Department of Upper GI surgery, James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK.
Clin Endosc. 2021 Jul;54(4):542-547. doi: 10.5946/ce.2020.243. Epub 2021 Mar 24.
BACKGROUND/AIMS: STRETTA improves the quality of life and reduces the need for anti-reflux medication in select patients, especially those with uncomplicated gastroesophageal reflux disease (GERD). We aimed to review the outcomes of STRETTA in patients with medically refractory GERD, who had undergone previous gastric surgery. METHODS: This was a review of a prospective database in a British center. Since 2016, all GERD patients who underwent STRETTA and had a history of previous gastric surgery were studied (n=11). Anti-reflux medication pre- and post-STRETTA was evaluated. The outcomes were assessed objectively by the change in anti-reflux medication and subjectively through a pre- and post-procedure GERD-health-related quality of life (HRQL) questionnaire. RESULTS: The median length of follow-up was 23 months. Nine patients demonstrated improved GERD-HRQL scores following STRETTA (82%). Of the 7 patients who underwent fundoplication, all reported improved symptoms, with 3 patients discontinuing the medication and 3 patients on a reduced dose of proton pump inhibitor. Four patients underwent surgery other than fundoplication, of which 2 reported improvement and discontinued the proton pump inhibitor. Two patients reported no improvement. CONCLUSION: This study demonstrates that STRETTA is successful in reducing refractory GERD in patients with previous gastric surgery. The outcomes were comparable to published outcomes in patients with uncomplicated GERD with no previous history of gastric surgery.
背景/目的:STRETTA可改善特定患者的生活质量,并减少抗反流药物的使用,尤其是那些患有单纯性胃食管反流病(GERD)的患者。我们旨在回顾STRETTA在既往接受过胃部手术的药物难治性GERD患者中的治疗效果。 方法:这是一项对英国某中心前瞻性数据库的回顾性研究。自2016年以来,对所有接受STRETTA治疗且有既往胃部手术史的GERD患者(n = 11)进行了研究。评估了STRETTA治疗前后的抗反流药物使用情况。通过抗反流药物的变化客观评估治疗效果,并通过治疗前后与GERD健康相关生活质量(HRQL)问卷主观评估治疗效果。 结果:中位随访时间为23个月。9例患者在接受STRETTA治疗后GERD-HRQL评分有所改善(82%)。在7例行胃底折叠术的患者中,所有患者均报告症状改善,其中3例患者停药,3例患者质子泵抑制剂剂量减少。4例接受胃底折叠术以外手术的患者中,2例报告症状改善并停用质子泵抑制剂。2例患者报告无改善。 结论:本研究表明,STRETTA在减少既往接受过胃部手术的患者的难治性GERD方面是成功的。其治疗效果与既往无胃部手术史的单纯性GERD患者的已发表治疗效果相当。
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