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Impact of Second-Generation Transoral Incisionless Fundoplication on atypical GERD symptoms: A Systematic Review and Meta-analysis.

Published:November 16, 2022DOI:https://doi.org/10.1016/j.gie.2022.11.002
Impact of Second-Generation Transoral Incisionless Fundoplication on atypical GERD symptoms: A Systematic Review and Meta-analysis.
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      Abstract

      Background & Aims

      Transoral Incisionless Fundoplication (TIF) using EsophyX device is a minimally invasive endoscopic fundoplication technique. Our study aimed to assess the efficacy of TIF for atypical GERD symptoms in patients with chronic or refractory GERD.

      Methods

      A systematic search of 4 major databases was performed. All original studies assessing atypical GERD using a validated symptom questionnaire (the Reflux Symptom Index (RSI) were included. The RSI score was assessed pre-and post-TIF at 6- and 12-month follow-up. The data on technical success rate, adverse events, proton pump inhibitor (PPI) use, and patient satisfaction were also collected. Only TIF procedures currently in practice using EsophyX device, i.e., TIF 2.0 and TIF with concomitant hiatal hernia repair (cTIF), were included in the review.

      Results

      A total of 10 studies (564 patients) were included. At 6- and 12- month follow-up, there was 15.72 (95% CI 12.15 to 19.29) and 14.73 points (95% CI 11.74 to 17.72) mean reduction of RSI score post-TIF, respectively, with a technical success rate of 99.5% and a pooled adverse event rate of 1%. At both time intervals, more than two-thirds of the patients were satisfied with their health condition and roughly three-fourths of the patients were off daily PPI.

      Conclusions

      Our study shows that TIF using the EsophyX device is safe and effective in reducing atypical GERD symptoms at 6- and 12-month follow-up. It improves patient-centered outcomes and can be a minimally invasive therapeutic option for patients suffering from atypical GERD symptoms on chronic medical therapy.
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      Article info

      Publication history

      Accepted: November 7, 2022
      Received in revised form: October 24, 2022
      Received: June 28, 2022

      Publication stage

      In Press Journal Pre-Proof

      Footnotes

      Funding: None

      Author Contributions:

      MH: Design, protocol development, literature search and review, statistical analysis, data interpretation and draft.

      JGB: Design, literature search and review, data interpretation and draft.

      UH: Design, literature search and review, data interpretation and draft.

      CB: Design, statistical analysis, data interpretation and draft.

      PAB: Design, literature search and review

      PJ: Design, data interpretation and review

      CT: Concept, Design, data interpretation, review and critically revised the article.

      Conflict of Interest:

      MH: None

      JGB: None

      UH: None

      CB: None

      PAB: None

      PJ: has received research support from Apollo Endosurgery, Fractyl and GI Dynamics, has served as a consultant to Endogastric Solutions and GI Dynamics, has received an honorarium from Obalon Therapeutics, and has received in-kind support from USGI Medical.

      CCT: is a consultant and received research support from Apollo Endosurgery, Boston Scientific, Fujifilm, GI Dynamics, Lumendi, Olympus, USGI Medical. Consultant for Medtronic and Fractyl. Institutional research grants from Aspire Bariatrics and ERBE. General partner for BlueFlame Healthcare. Founder/Consultant/Board Member for Envision Endoscopy, Enterasense and GI Windows.

      Identification

      DOI: https://doi.org/10.1016/j.gie.2022.11.002

      Copyright

      © 2022 by the American Society for Gastrointestinal Endoscopy

      ScienceDirect

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