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Endoscopy 2022; 54(03): 305-309
DOI: 10.1055/a-1446-8953
Innovations and brief communications

Is transoral incisionless fundoplication (TIF) an answer to post-peroral endoscopic myotomy gastroesophageal reflux? A multicenter retrospective study

Olaya I. Brewer Gutierrez 
1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States
,
Kenneth J. Chang
2   Division of Gastroenterology, University of California Irvine, Irvine, United States
,
Petros C. Benias
3   Division of Gastroenterology, Lenox Hill Hospital, New York, United States
,
Alireza Sedarat
4   Division of Digestive Diseases, Ronald Reagan UCLA Medical Center, Santa Monica, United States
,
Mohamad H. Dbouk
1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States
,
Gala Godoy Brewer
1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States
,
David P. Lee
5   Division of Gastroenterology, University of California Irvine, Irvine, United States
,
Patrick I. Okolo III
6   Division of Gastroenterology, Lenox Hill Hospital, New York, United States (Ringgold ID: RIN5945)
,
Marcia I. Canto
1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States
,
Mouen A. Khashab
1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, Baltimore, Maryland, United States
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Author commentary on Olaya I. Brewer Gutierrez et al.Endoscopy 2022; 54(03): v12-v12
DOI: 10.1055/a-1506-2250

Abstract

Background: The use of peroral endoscopic myotomy (POEM) for achalasia has a high incidence of post-procedural gastroesophageal reflux (GER). Transoral incisionless fundoplication (TIF) may be an ideal endoscopic treatment. We report our experience with the use of post-POEM TIF.

Methods: In this multicenter retrospective study, post-POEM patients with GER who underwent TIF were included. The study end points were: (i) technical success; (ii) safety; (iii) effectiveness (changes in symptoms, scores, proton pump inhibitor [PPI] use, pH studies).

Results: 12 patients underwent TIF after POEM, nine of whom had daily symptoms, with 91.7% requiring twice daily (BID) PPIs. Technical success was achieved in all patients. Two adverse events occurred. There were significant decreases in the percentage of patients on BID PPIs (P = 0.03), frequency of daily symptoms (P = 0.03), Reflux Severity Index questionnaire, and GERD Health-related Quality of Life scores (P = 0.03 and P = 0.003; n = 6). pH studies performed in seven of the patients showed a significant reduction in the mean DeMeester score (P = 0.05) and mean percentage acid exposure time (P = 0.04).

Conclusion: Our experience suggests that TIF may be effective and safe in treating GER after POEM. Larger prospective trials are needed.

Supplementary material



Publication History

Received: 20 August 2020

Accepted after revision: 22 February 2021

Article published online:
28 May 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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