Endoscopy 2018; 50(04): S36
DOI: 10.1055/s-0038-1637134
ESGE Days 2018 oral presentations
20.04.2018 – Esophagus: SCC, Barrett's, GERD
Georg Thieme Verlag KG Stuttgart · New York

ESOPHYX2.0 AND MUSE SYSTEMS FOR TRANSORAL INCISIONLESS FUNDOPLICATION (TIF) FOR TREATMENT OF GASTRO-ESOPHAGEAL REFLUX DISEASE (GERD): 6- AND 12-MONTH RESULTS FROM A SINGLE-CENTER RETROSPECTIVE STUDY

PA Testoni
1   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
,
G Mazzoleni
2   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Division of Gastroenterology and GI Endoscopy, Milan, Italy
,
G DiStefano
1   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
,
S Testoni
1   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
,
L Fanti
1   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
,
M Antonelli
1   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
,
S Passaretti
1   San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

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Aims:

EsophyX2.0 (EndoGastric Solutions) creates a 270 ° circumferential valve by deploying polypropylene fasteners under endoscopic vision. MUSE (Medigus Ultrasonic Surgical Endostapler) creates a fundoplication similar to Dor-Thal by using a surgical endostapler to place metal stitches under ultrasound-guide. Aim of the study: to retrospectively compare clinical, pathophysiological and endoscopic results at 6 and 12 months after TIF with the two systems.

Methods:

GERD-HRQL score, PPI use, DeMeester score, total number of refluxes detected by esophageal impedance and esophagitis rate were assessed. Data were compared by Chi-squared test.

Results:

We performed 49 TIF with EsophyX (2007 – 2012) and 28 with MUSE (2015 – 2017). Two pneumothorax with EsophyX and 1 esophageal perforation with MUSE occurred (complication rate: 2% vs. 3.5%). 1/28pt (3.6%) after MUSE and 4/49pts (8.2%) after EsophyX requested surgery. All pts undergone EsophyX completed follow-up (FU). Among pts undergone MUSE, at 6- and 12-month, 21 and 14 completed clinical FU, 12 and 7 completed pathophysiological FU, 18 and 11 completed endoscopic FU. At 6-month PPI were stopped in 61% and 67% of pts and halved in 22% and 22% after EsophyX and MUSE. At 12-month FU, PPI were stopped in 51% and 64% of pts and halved in 29% and 29% of pts after EsophyX and MUSE. In EsophyX and MUSE group, GERD-HRQL scores were: 46 ± 19 and 39 ± 16 pre-TIF, 15 ± 13 and 16 ± 14 at 6-month, 16 ± 13 and 13 ± 11 at 12-month; DeMeester scores were: 22 ± 12 and 23.6 ± 18.9 pre-TIF, 18 ± 15 and 29 ± 24 at 6-month, 19 ± 20 and 24 ± 18 at 12-month; number of total refluxes was: 66 ± 40 and 58 ± 37 pre-TIF, 38 ± 37 and 38 ± 31 at 6-month, 43 ± 35 and 30 ± 23 at 12-month; number of esophagitis/pts was: 11/49 (22%) and 8/28 (29%) pre-TIF, 6/49 (12%) and 6/18 (33%) at 6-month, 6/49 (12%) and 2/11 (18%) at 12-month.

Conclusions:

At 6 and 12-month follow-up, there were no statistically significant difference in clinical, pathophysiological and endoscopic results between TIF with EsophyX and MUSE systems.