PSS Castelijns1, BPL Witteman2, A Peeters1, MCG vd Poll1, GH Koek1, JM Conchillo1, LPS Stassen1, ND Bouvy1. 1MUMC+, 2Rijnstate
Aims: Transoral incisionless fundoplication (TIF) was developed in an attempt to create a minimally invasive endoscopic procedure that mimics antireflux surgery. Few studies report on long-term results with a high rate of resumption on PPI. The objective of this study to report the long-term result on a randomized controlled trial comparing TIF with proton pump inhibitors (PPI). Secondary objective was to identify pre-operative predictors for successful outcome.
Methods: All patients that underwent TIF as an intervention in the previously published randomized controlled trial between 2008 and 2012, were contacted by mail end sent the GERD-HRQL questionnaires. Additional questions regarding current PPI use and reoperations were added to the questionnaire to assure an adequate outcome measurement. A lower Quality of life score represents better outcome, with 0 as the maximum quality of life. Non-responders were contacted once by phone to maximize response rate.
Results: Sixty patients were contacted, from which 45 responded. One patient died during follow-up due to unrelated cause, three refused to fill in the questionnaire; therefore, response rate is 74.6% with a mean follow-up of 7.3 (SD 1.2) years. At follow up, quality of life score was 9.0(SD 9.3) compared with 27.1(SD 8.4) at baseline (p<0.05). 43.9% of the patients reported to be satisfied with their health compared with 11.7% at baseline (p<0.05). ³50% improvement in GERD-HRQL score was seen as a successful outcome. Pre-operative Hill classification, the presence of motility disorders, presence of hiatal hernia and degree of regurgitation were all put into a multi-variate analysis to predict what type of patient has the highest success rate with TIF2.
Conclusions: This is the first study reporting on 7-year follow-up after TIF, with significant improvement of quality of life score. However, a large number of patients requires daily PPI and 22.2% of the patients needed anti-reflux surgery in addition to EsophyX to control their symptoms. Still, there is a small group of patients that benefit from TIF procedure after long-term follow-up.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 91249
Program Number: ETP869
Presentation Session: Emerging Technology iPoster Session (Non CME)
Presentation Type: Poster