TRANSORAL INCISIONLESS FUNDOPLICATION WITH OR WITHOUT HIATAL HERNIA REPAIR FOR GASTROESOPHAGEAL REFLUX DISEASE AFTER PERORAL ENDOSCOPIC MYOTOMY

Background: Gastroesophageal reflux disease (GERD) following peroral endoscopic myotomy (POEM) occurs in 40-60% of patients. There are limited data evaluating antireflux surgery or transoral incisionless fundoplication (TIF) for refractory post-POEM GERD. Methods: In a single center prospective cohort study, consecutive patients with medically refractory post-POEM regurgitation and/or GERD treated with TIF or combined laparoscopic hernia repair and TIF (cTIF) were evaluated. Baseline evaluation: GERD-Health Related Quality of Life (GERD-HQRL) and Reflux Symptom Questionnaire 7-day recall (RESQ-7) questionnaires, EGD, high-resolution manometry (HRM), 48-hour pH test off PPIs and impedance planimetry of the esophagogastric junction (EGJ) to calculate the distensibility index (EGJ-DI). A proton-pump inhibitor (PPI) was taken twice daily for two weeks after TIF and restarted later if required. Patients returned 9-12 months after treatment when all preoperative studies were repeated. Quality of life, pH studies and EGJ metrics before and after antireflux surgery were compared. Results: 17 patients underwent TIF (n=2, 12%) or cTIF (n=15, 88%) a mean 25±15 months after POEM. At follow-up a mean of 9±1 months after TIF/cTIF, patients required less frequent daily PPIs (n=0.001), were more satisfied (p=0.008), had improved GERD-HQRL (p=0.001), less intensity and frequency of GERD (p=0.001) and fewer reflux episodes (p=0.04) by pH testing. There was no change in EGJ-DI, EGJ diameter, integrated relaxation pressure, % total time pH<4, or DeMeester score. Conclusions: TIF and cTIF for difficult-to-control post-POEM GERD appear safe, decreases PPI use and reflux episodes, and improves QOL without significant change in IRP, EGJ compliance, or esophageal acid exposure time.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: TRANSORAL INCISIONLESS FUNDOPLICATION WITH OR WITHOUT HIATAL HERNIA REPAIR FOR GASTROESOPHAGEAL REFLUX DISEASE AFTER PERORAL ENDOSCOPIC MYOTOMY ; day:21 ; month:11 ; year:2023 ; Endoscopy International Open ; (21.11.2023)

Contributors, Places and Time

• Contributor: DeWitt, John M. ; Al-Haddad, Mohammad ; Stainko, Sarah ; Perkins, Anthony ; Fatima, Hala ; Ceppa, DuyKhanh P. ; Birdas, Thomas J.

Further information

• DOI: 10.1055/a-2215-3415
• URN: urn:nbn:de:101:1-2024010412460428588768
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 15.08.2025, 7:24 AM CEST