The role of transoral incisionless fundoplication (TIF) in the management of gastroesophageal reflux disease (GERD) following peroral endoscopic myotomy (POEM) : A pilot, prospective, patient-driven study

Copyright © 2024 Copyright: © 2024 Saudi Journal of Gastroenterology..

BACKGROUND: Gastroesophageal reflux (GERD) is a concern after peroral endoscopic myotomy (POEM). Transoral incisionless fundoplication (TIF) has been recently described as a possible therapy for post-POEM GERD in case series.

METHODS: We prospectively enrolled patients undergoing POEM who agreed to participate in objective post-procedure GERD evaluation. Patients with objective evidence of GERD and suitable anatomy were offered TIF vs. proton pump inhibitor (PPI) only. Patients who underwent TIF were compared to those on PPI-only therapy after follow-up.

RESULTS: Of 21 enrolled POEM patients with objective testing, GERD was found in 11 (52%). Of those eligible for TIF, 4 (40%) opted to pursue TIF and were compared to those on PPI-only therapy (n = 6). Three months post-TIF, 75% of patients had discontinued or significantly decreased PPI. There were no adverse events. GERD health-related quality of life scores were low and comparable between TIF (3.75 ± 6.2) and those who remained on PPI-only therapy (4.1 ± 5).

CONCLUSION: In this pilot, patient-driven prospective study, 75% of patients with post-POEM GERD undergoing TIF had stopped or significantly reduced PPI use. Post-POEM TIF is safe and effective and may be a viable alternative to PPI for POEM-related GERD; however, future studies should include a control arm and post-intervention pH monitoring.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - year:2024

Enthalten in:

Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association - (2024) vom: 11. März

Sprache:

Englisch

Beteiligte Personen:

Ayoub, Fares [VerfasserIn]
Keihanian, Tara [VerfasserIn]
Zabad, Noor [VerfasserIn]
Jawaid, Salmaan [VerfasserIn]
Patel, Kalpesh [VerfasserIn]
Othman, Mohamed O [VerfasserIn]

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Journal Article

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Date Revised 11.03.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.4103/sjg.sjg_22_24

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369551761