Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 85 Wujin Road, Shanghai, 200080, China.
Shanghai General Hospital of Nanjing Medical University, Nanjing, China.
Esophagus. 2023 Jul;20(3):581-586. doi: 10.1007/s10388-023-00992-3. Epub 2023 Mar 6.
To evaluate the long-term efficacy of transoral incisionless fundoplication (TIF) with Medigus Ultrasonic Surgical Endostapler (MUSE) for gastroesophageal reflux disease (GERD).
A total of 16 patients with proton pump inhibitor-dependent gastroesophageal reflux disease had undergone TIF by MUSE in Shanghai General Hospital （Shanghai, China）from March 2017 to December 2018. Patients were followed up at 6 months, and the GERD-health-related quality of life (GERD-HRQL) questionnaire score, the GERD questionnaire (GERD-Q) score, high-resolution esophageal manometry (HREM) and 24 h esophageal pH parameters, the Hill grade of the gastroesophageal flap valve (GEFV) and daily Proton pump inhibitor (PPI) consumption before and after procedure were compared. Patients also were followed up at 3 years and 5 years using a structured questionnaire via phone which evaluated symptoms of reflux, dose of PPI medication and side effects.
Follow-up data were collected from 13 patients, ranging from 38 to 63 months, 53 months on average. 10/13 patients reported symptomatic improvement and daily PPI consumption was stopped or halved in 11/13. After procedure, the mean scores of GERD-HRQL and GERD-Q were significantly increased. The mean DeMeester score, the mean acid exposure time percentage and the mean number of acid reflux episodes were significantly lower. The mean rest pressure at lower esophageal sphincter (LES) had no significant difference.
TIF by MUSE has significant efficacy in the treatment of PPI-dependent GERD, which can improve symptoms and life quality of patients, and reduce the acid exposure time for long-term. Chictr.org.cn.
ChiCTR2000034350.
评估经口无切口胃底折叠术（TIF）联合 Medigus 超声切割缝合器（MUSE）治疗胃食管反流病（GERD）的长期疗效。
2017 年 3 月至 2018 年 12 月，上海交通大学附属第六人民医院采用 MUSE 行经口无切口胃底折叠术（TIF）治疗质子泵抑制剂（PPI）依赖型 GERD 患者 16 例。术后 6 个月时进行随访，比较患者 GERD 健康相关生活质量（GERD-HRQL）问卷评分、GERD 问卷（GERD-Q）评分、高分辨率食管测压（HREM）和 24 h 食管 pH 参数、胃食管瓣（GEFV）Hill 分级以及治疗前后每日 PPI 消耗量。术后 3 年和 5 年通过电话采用结构化问卷进行随访，评估患者的反流症状、PPI 药物剂量和不良反应。
13 例患者（年龄 38 至 63 岁，平均 53 岁）完成了随访。10/13 例患者报告症状改善，11/13 例患者停止或减半服用 PPI。术后 GERD-HRQL 和 GERD-Q 评分均显著升高，DeMeester 评分、酸暴露时间百分比和酸反流次数均显著降低，食管下括约肌（LES）静息压无显著差异。
MUSE 行经口无切口胃底折叠术治疗 PPI 依赖型 GERD 疗效显著，可改善患者症状和生活质量，降低酸暴露时间，长期疗效良好。ChiCTR2000034350.
