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Erschienen in: Surgical Endoscopy 4/2012

01.04.2012

Endoscopic full-thickness plication versus laparoscopic fundoplication: a prospective study on quality of life and symptom control

verfasst von: Stavros A. Antoniou, Oliver O. Koch, Adolf Kaindlstorfer, Kai U. Asche, Johannes Berger, Frank A. Granderath, Rudolph Pointner

Erschienen in: Surgical Endoscopy | Ausgabe 4/2012

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Abstract

Background

Endoscopic antireflux techniques have emerged as alternative therapies for gastroesophageal reflux disease (GERD). Endoscopic plication receives continuing interest as an effective and safe procedure. This treatment option has not been the subject of comparison with well-established operative therapies to date. The present study aimed at comparatively evaluating the effectiveness of endoscopic plication and laparoscopic fundoplication in terms of quality of life and symptom control.

Methods

Between October 2006 and April 2010, 60 patients with documented GERD were randomly assigned to undergo either endoscopic plication or laparoscopic fundoplication. Quality-of-life scores and symptom grading were recorded before treatment and at 3- and 12-month follow-up. Outcomes were compared with the statistical significance set at a p value of 0.05.

Results

Twenty-nine patients from the endoscopic group and 27 patients from the operative group were available at follow-up. Quality-of-life scores showed a substantial and similar increase for both groups after treatment. Symptoms of heartburn (p < 0.02), regurgitation (p < 0.004), and asthma (p = 0.03) were significantly improved in the endoscopic group, whereas laparoscopic fundoplication was more effective in controlling symptoms of heartburn (p < 0.01) and regurgitation (p < 0.05) compared to the endoscopic procedure.

Conclusions

Endoscopic plication and laparoscopic fundoplication resulted in significant symptom improvement with similar quality-of-life scores in a selected patient population with GERD, whereas operative treatment was more effective in the relief of heartburn and regurgitation at the expense of higher short-term dysphagia rates.
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Metadaten
Titel
Endoscopic full-thickness plication versus laparoscopic fundoplication: a prospective study on quality of life and symptom control
verfasst von
Stavros A. Antoniou
Oliver O. Koch
Adolf Kaindlstorfer
Kai U. Asche
Johannes Berger
Frank A. Granderath
Rudolph Pointner
Publikationsdatum
01.04.2012
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 4/2012
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-011-1999-0

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