Comparing the feasibility, safety, and efficacy of Stretta radiofrequency and anti-reflux ablation therapy for treating patients with refractory gastroesophageal reflux disease: A retrospective, single-center cohort study.

BACKGROUND AND AIMS

This study compared Stretta radiofrequency (SRF) and anti-reflux ablation therapy (ARAT) using argon plasma coagulation (APC) for the treatment of refractory chronic gastroesophageal reflux disease (GERD).

METHODS

The primary focus of this single-center retrospective cohort study involving 329 patients was the change in GERD questionnaire (GERDQ) scores. Secondary measures included Los Angeles (LA) classification, Hill's flap valve grade (FVG), proton pump inhibitor (PPI) discontinuation rate, Barrett's esophagus resolution rate, and incidence of adverse events. A subgroup analysis compared ARAT with two-thirds or full-width extent with multiple ARAT treatments and SRF, focusing on the primary outcomes.

RESULTS

There were no notable between-group differences in median GERDQ score changes; however, the SRF group exhibited a higher PPI withdrawal rate (P = 0.005). The ARAT group showed greater improvement in the median FVG and resolution rate of Barrett's esophagus (P < 0.001). Comparing wider extent ablation in ARAT with SRF, symptom alleviation and PPI discontinuation rates were similar, but ARAT was superior in LA grade improvement without any increase in side effects (P < 0.001). Repeated ARAT treatments aligned more closely with SRF in terms of GERDQ score improvement.

CONCLUSION

Both groups showed similar improvements in GERDQ scores; however, SRF was more effective in terms of PPI withdrawal and caused fewer complications. In contrast, ARAT was better at improving Hill's valve grading and resolving Barrett's esophagus.