• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Strategic Plan, 2020-2023
    • Committees
      • Descriptions and Video Updates
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • COVID-19 Announcements
    • SAGES 2020 Meeting Information
    • 2021 Scientific Session Call For Abstracts
    • 2021 Emerging Technology Session Call For Abstracts
    • 2018 Prevent BDI Consensus Conference
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • Leadership Development and Health Policy Conference Videos
      • SAGES Quality Summit Meeting
      • SAGES 2019
      • SAGES 2018
      • SAGES 2017
      • SAGES 2016
      • SAGES 2015
      • SAGES 2014
      • SAGES 2013
    • Related Meetings Calendar
  • Membership
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • COVID-19 Annoucements
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • Troubleshooting Guides
  • Education
    • SAGES.TV Video Library
    • Virtual Hernia Clinic
    • The SAGES Safe Cholecystectomy Program
    • The Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • The SAGES HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Endorsed Courses
    • SAGES Robotics Fellows Courses
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Educational Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES Quality Initiative
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • SAGES Research Opportunities
    • SAGES Endorsed Courses
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
    • Fellowship Certification
  • Search
    • COVID-19 Announcements
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Blog
    • All Blog Posts
    • COVID-19
    • Notes from the Battlefield
    • A (Positive) Way Forward
    • President Posts
  • Log In

Electrical Stimulation Therapy (EST) of the Lower Esophageal Sphincter (LES) Is Successful in Treating GERD – Final Results of Open-label Prospective Trial

Leonardo Rodríguez, MD, Patricia Rodríguez, RN, Beatriz Gómez, BSc, Juan C Ayala, MD, Jorge Saba, MD, Alberto Perez-castilla, MD, Manoel. G Neto, MD. Surgery, CCO OBESIDAD Y DIABETES, Santiago, Chile

 

Background: Improvement in LES pressures using EST was previously demonstrated in animals and GERD patients using temporary endoscopic and laparoscopic leads.
Aims: The aim of this prospective open-label human trial was to study the safety and efficacy of long-term LES-EST using a laparoscopically implanted neurostimulator in GERD patients.
Methods: GERD patients at least partially responsive to proton pump inhibitors (PPI) and had off-PPI GERD HRQL>20, basal LES end-expiratory pressures (EEP) of 5-15 mmHg, % 24 hour esophageal pH<4.0 for >5%, hiatal hernia < 3cm and esophagitis < LA Grade C were included in the trial. Bipolar stitch electrodes were laparoscopically placed in the LES and an implantable pulse generator (EndoStim Inc., St. Louis, MO, USA) was placed subcutaneously in the anterior abdominal wall. EST at 20 Hz, 200usec, 3-8mAmp in 30 minutes sessions was delivered starting on day 1 post-implant. The sessions were delivered pre-meal and at night. Patients were evaluated using GERD-HRQL, symptom diaries and SF-12 at baseline and every month for six months thereafter and underwent esophageal pH at 0, 1, 3 and months and high resolution manometry testing at 0, 1, 3 months. Stimulation sessions were optimized based on residual symptoms and lead impedance at follow-up.
Results: Twenty-four patients [mean age (sd) = 53 (12) years; men=14] were successfully implanted and have completed their 6 month evaluation. 

Effect of LES-EST on Patient symptoms, Esophageal pH and LES pressure
  Baseline Month 3 Month 6
Mean GERD-HRQL off-PPI 23.7 (3.5) 4.2 (3.3) 2.5 (3.1)
Median % 24-hour Esophageal pH<4.0 11.1 (6.5) 7.5 (4.5) 4.9 (5.3)
Mean LES End Expiratory Pressure 8.6 (0.5) 15.4 (1.4) No HRM

(p<0.001 for all comparisons vs. baseline)

There was a significant reduction in number of days patient reported heartburn (45% vs. 91%, p<0.001) and regurgitation (17% vs. 69%; p<0.001) on EST compared to off-PPI. At their last follow-up all patients were off their daily PPI and had significantly better GERD-HRQL on LES-EST compared to on-PPI [2.5 (3.1) vs. 9.8 (6.3); p<0.001]. There was a significant improvement in both physical and mental scores on SF-12 quality of life measurement at follow-up compared to both on and off PPI scores (p<0.01). There were no implantation- or stimulation-related unanticipated adverse events, or untoward sensation due to stimulation. The swallowing function was also unaffected by EST.
Conclusion: During the long term follow-up of 6 months, LES-EST was safe and effective for treating patients with GERD. There was a significant and sustained improvement in symptoms, esophageal acid exposure and LES pressures. Further, LES-EST can be optimized to individual patient needs. All patients had received significant clinical benefit from LES-EST and the trial has been extended to two year. One year follow-up results of this trial will be available for presentation in March 2012.
 


Session Number: SS18 – Foregut
Program Number: S095

Post Views: 251

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2012 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Free SAGES Webinar: Lessons from COVID on Living and Thriving as Surgeons

SAGES recognizes that the COVID-19 pandemic has had a big impact on surgical practice and in surgeon wellness. SAGES’ Reimagining the Practice of Surgery Taskforce will present “Finding the Opportunities: Lessons from COVID and How We Live and Thrive as Surgeons”  to look at ways in which innovative leadership at various levels may help transform […]

Daniel Herron, MD

An opportunity to slow down and appreciate the small joys in life

Dan Herron, MD shares insights with Dana Telem, MD on lessons learned from COVID-19 Fear, anxiety and uncertainty has dominated the first half of 2020. Never before have we, as healthcare providers, been asked to do so much with so little—whether it’s resources like personal protective equipment, dusting off skills related to critical care, or […]

covid testing stock

Notes from the Battlefield – May 14, 2020

Coronavirus Global Surgical Collaborative (CVGSC)* An initiative sponsored by SAGES in collaboration with EAES, AEC, KSELS, and ELSA A group of surgical leaders from affected countries have joined to discuss what they are learning during this Covid-19 Global crisis. The following is a brief summary of what they feel may be useful information to disseminate to the surgical […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Newsletter Subscription

  • This field is for validation purposes and should be left unchanged.

Important Links

SAGES 2020 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

[footer_backtotop] · Log in

Copyright © 2021 Society of American Gastrointestinal and Endoscopic Surgeons · Legal
· Managed by BSC Management, Inc