WebMD Medical News
Louise Chang, MD
Jan. 20, 2009 -- Researchers report promising results for new procedures to
treat GERD without making any surgical
incisions in the skin.
Both treatments are endoscopic, meaning that doctors perform the procedures
via a tiny tube passed through the mouth and guided to the junction of the
stomach and the esophagus. That's where the lower esophageal sphincter is
located; the major cause of
GERD is the lower esophageal sphincter not working properly.
GERD patients that don't respond to drug treatment are sometimes referred
for laparoscopic surgery, which requires the surgeon to make small incisions in
Instead of laparoscopic surgery, doctors at Emory University and the Medical
College of Georgia performed endoscopic procedures on 126 patients with
Some of those patients got a procedure called full-thickness plication
(FTP), in which doctors stitched a tissue valve at the lower esophageal
sphincter. Other patients got endoscopic radiofrequency treatment to tone the
lower esophageal sphincter to make it work better.
After their procedure the patients were followed for six months, on average.
During that time, patients in both groups cut back on their use of proton pump
inhibitors (PPIs) to treat GERD and had a drop in voice problems related to
GERD and less difficulty in swallowing.
The radiofrequency treatment group also had a drop in the percentage of
patients with moderate to severe GERD.
"Our experience indicates that both procedures are effective, providing
symptomatic relief and reduction in PPI use," Emory's Louis Jeansonne IV,
MD, and colleagues write in the Archives of Surgery.
"Both procedures resulted in GERD symptom improvement and demonstrated
an excellent safety profile," but the long-term results aren't clear yet
and there was no comparison with sham treatment or laparoscopic surgery, notes
Jon Gould, MD, of the surgery department at the University of Wisconsin Medical
SOURCES:Jeansonne, L. Archives of Surgery, January 2009; vol 144: pp
19-24.Gould, J. Archives of Surgery, January 2009; vol 144: p 24.
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