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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 World+J+Gastrointest+Pharmacol+Ther
2016 ; 7
(2
): 179-89
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Transoral incisionless fundoplication for gastro-esophageal reflux disease:
Techniques and outcomes
#MMPMID27158533
Testoni PA
; Mazzoleni G
; Testoni SG
World J Gastrointest Pharmacol Ther
2016[May]; 7
(2
): 179-89
PMID27158533
show ga
Gastro-esophageal reflux disease (GERD) is a very common disorder that results
primarily from the loss of an effective antireflux barrier, which forms a
mechanical obstacle to the retrograde movement of gastric content. GERD can be
currently treated by medical therapy, surgical or endoscopic transoral
intervention. Medical therapy is the most common approach, though concerns have
been increasingly raised in recent years about the potential side effects of
continuous long-term medication, drug intolerance or unresponsiveness, and the
need for high dosages for long periods to treat symptoms or prevent recurrences.
Surgery too may in some cases have consequences such as long-lasting dysphagia,
flatulence, inability to belch or vomit, diarrhea, or functional dyspepsia
related to delayed gastric emptying. In the last few years, transoral
incisionless fundoplication (TIF) has proved an effective and promising
therapeutic option as an alternative to medical and surgical therapy. This review
describes the steps of the TIF technique, using the EsophyX(®) device and the
MUSE(TM) system. Complications and their management are described in detail, and
the recent literature regarding the outcomes is reviewed. TIF reconfigures the
tissue to obtain a full-thickness gastro-esophageal valve from inside the
stomach, by serosa-to-serosa plications which include the muscle layers. To date
the procedure has achieved lasting improvement of GERD symptoms (up to six
years), cessation or reduction of proton pump inhibitor medication in about 75%
of patients, and improvement of functional findings, measured by either pH or
impedance monitoring.