Transoral incisionless fundoplication: is it as safe and efficacious as a Nissen or Toupet fundoplication?
Transoral incisionless fundoplication (TIF) was U.S. Food and Drug Administration-approved in 2007 to treat gastroesophageal reflux disease (GERD), but comparative data are lacking. This study was undertaken to compare outcomes for patients with GERD undergoing TIF versus laparoscopic Nissen or Toup...
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| Veröffentlicht in: | The American surgeon 2014-09, Vol.80 (9), p.860-867 |
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| creator | Toomey, Paul Teta, Anthony Patel, Krishen Ross, Sharona Sukharamwala, Prashant Rosemurgy, Alexander S |
| description | Transoral incisionless fundoplication (TIF) was U.S. Food and Drug Administration-approved in 2007 to treat gastroesophageal reflux disease (GERD), but comparative data are lacking. This study was undertaken to compare outcomes for patients with GERD undergoing TIF versus laparoscopic Nissen or Toupet fundoplications. We undertook a case-controlled study of three cohorts of 20 patients undergoing TIF or laparoscopic Nissen or Toupet fundoplications from 2010 to 2013 controlling for age, body mass index, and preoperative DeMeester scores. All patients were prospectively followed. Median data are reported. Patients undergoing TIF had significantly shorter operative times (in minutes: 71 vs 119 and 85, respectively, P < 0.001) and length of stay (in days: 1, 2, and 1, respectively, P < 0.001). No matter the approach, patients reported dramatic and similar reduction in symptom frequency and severity (e.g., heartburn 8 to 0, P < 0.05). At follow-up, 83 per cent of patients after TIF, 80 per cent after Nissen, or 92 per cent after Toupet fundoplications had symptoms less than once per month (P = 0.12). TIF leads to dramatic symptom resolution, similar when compared with Nissen or Toupet fundoplications. TIF promotes shorter operative times and lengths of stay. Patient satisfaction and effective palliation of symptoms show that TIF is safe and efficacious in comparison to Nissen and Toupet fundoplications and support its continued application and evaluation. |
| doi_str_mv | 10.1177/000313481408000918 |
| format | Article |
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This study was undertaken to compare outcomes for patients with GERD undergoing TIF versus laparoscopic Nissen or Toupet fundoplications. We undertook a case-controlled study of three cohorts of 20 patients undergoing TIF or laparoscopic Nissen or Toupet fundoplications from 2010 to 2013 controlling for age, body mass index, and preoperative DeMeester scores. All patients were prospectively followed. Median data are reported. Patients undergoing TIF had significantly shorter operative times (in minutes: 71 vs 119 and 85, respectively, P < 0.001) and length of stay (in days: 1, 2, and 1, respectively, P < 0.001). No matter the approach, patients reported dramatic and similar reduction in symptom frequency and severity (e.g., heartburn 8 to 0, P < 0.05). At follow-up, 83 per cent of patients after TIF, 80 per cent after Nissen, or 92 per cent after Toupet fundoplications had symptoms less than once per month (P = 0.12). TIF leads to dramatic symptom resolution, similar when compared with Nissen or Toupet fundoplications. TIF promotes shorter operative times and lengths of stay. Patient satisfaction and effective palliation of symptoms show that TIF is safe and efficacious in comparison to Nissen and Toupet fundoplications and support its continued application and evaluation.</description><identifier>ISSN: 0003-1348</identifier><identifier>EISSN: 1555-9823</identifier><identifier>DOI: 10.1177/000313481408000918</identifier><identifier>PMID: 25197871</identifier><language>eng</language><publisher>United States: SAGE PUBLICATIONS, INC</publisher><subject>Aged ; Body mass index ; Case-Control Studies ; Chest Pain - etiology ; Conversion to Open Surgery - statistics & numerical data ; Cough - etiology ; Deglutition Disorders - etiology ; Drug therapy ; FDA approval ; Feasibility Studies ; Female ; Follow-Up Studies ; Fundoplication - adverse effects ; Fundoplication - methods ; Gastroesophageal reflux ; Gastroesophageal Reflux - surgery ; Heartburn - etiology ; Humans ; Laparoscopy ; Laryngopharyngeal Reflux - etiology ; Length of Stay ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures - adverse effects ; Minimally Invasive Surgical Procedures - methods ; Operative Time ; Osteoporosis ; Patient Satisfaction ; Patients ; Prospective Studies ; Treatment Outcome</subject><ispartof>The American surgeon, 2014-09, Vol.80 (9), p.860-867</ispartof><rights>Copyright Southeastern Surgical Congress Sep 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-95bf967a92b227d8f7404b1d760f64d23fbd72c531011e98bdd6df7cb36d82c23</citedby><cites>FETCH-LOGICAL-c375t-95bf967a92b227d8f7404b1d760f64d23fbd72c531011e98bdd6df7cb36d82c23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25197871$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Toomey, Paul</creatorcontrib><creatorcontrib>Teta, Anthony</creatorcontrib><creatorcontrib>Patel, Krishen</creatorcontrib><creatorcontrib>Ross, Sharona</creatorcontrib><creatorcontrib>Sukharamwala, Prashant</creatorcontrib><creatorcontrib>Rosemurgy, Alexander S</creatorcontrib><title>Transoral incisionless fundoplication: is it as safe and efficacious as a Nissen or Toupet fundoplication?</title><title>The American surgeon</title><addtitle>Am Surg</addtitle><description>Transoral incisionless fundoplication (TIF) was U.S. Food and Drug Administration-approved in 2007 to treat gastroesophageal reflux disease (GERD), but comparative data are lacking. This study was undertaken to compare outcomes for patients with GERD undergoing TIF versus laparoscopic Nissen or Toupet fundoplications. We undertook a case-controlled study of three cohorts of 20 patients undergoing TIF or laparoscopic Nissen or Toupet fundoplications from 2010 to 2013 controlling for age, body mass index, and preoperative DeMeester scores. All patients were prospectively followed. Median data are reported. Patients undergoing TIF had significantly shorter operative times (in minutes: 71 vs 119 and 85, respectively, P < 0.001) and length of stay (in days: 1, 2, and 1, respectively, P < 0.001). No matter the approach, patients reported dramatic and similar reduction in symptom frequency and severity (e.g., heartburn 8 to 0, P < 0.05). At follow-up, 83 per cent of patients after TIF, 80 per cent after Nissen, or 92 per cent after Toupet fundoplications had symptoms less than once per month (P = 0.12). TIF leads to dramatic symptom resolution, similar when compared with Nissen or Toupet fundoplications. TIF promotes shorter operative times and lengths of stay. Patient satisfaction and effective palliation of symptoms show that TIF is safe and efficacious in comparison to Nissen and Toupet fundoplications and support its continued application and evaluation.</description><subject>Aged</subject><subject>Body mass index</subject><subject>Case-Control Studies</subject><subject>Chest Pain - etiology</subject><subject>Conversion to Open Surgery - statistics & numerical data</subject><subject>Cough - etiology</subject><subject>Deglutition Disorders - etiology</subject><subject>Drug therapy</subject><subject>FDA approval</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundoplication - adverse effects</subject><subject>Fundoplication - methods</subject><subject>Gastroesophageal reflux</subject><subject>Gastroesophageal Reflux - surgery</subject><subject>Heartburn - etiology</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laryngopharyngeal Reflux - etiology</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures - adverse effects</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>Operative Time</subject><subject>Osteoporosis</subject><subject>Patient Satisfaction</subject><subject>Patients</subject><subject>Prospective Studies</subject><subject>Treatment Outcome</subject><issn>0003-1348</issn><issn>1555-9823</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNplkT1rHDEQhkWIyV1s_wEXRpDGzcYaafWxaYI5Ejtg7OZcL1p9gI691UWzW-TfW8c5KZxqvp55eZkh5ArYVwCtbxljAkRroGWm5h2YD2QNUsqmM1x8JOsj0ByJFfmMuKtlqyR8IisuodNGw5rstsVOmIsdaZpcwpSnMSDSuEw-H8bk7Fxb32hCmmZqkaKNgdrJ0xBjnbqUFzz2LX1KiGGiudBtXg5hfqfx_YKcRTtiuHyL5-Tl54_t5qF5fL7_tbl7bJzQcm46OcROadvxgXPtTdQtawfwWrGoWs9FHLzmTgpgAKEzg_fKR-0GobzhjotzcnPSPZT8ewk49_uELoyjnUI124NUANywVlT0yzt0l5cyVXeVkp1RgilWKX6iXMmIJcT-UNLelj89sP74if7_T9Sl6zfpZdgH_2_l7-nFK1nLgyM</recordid><startdate>201409</startdate><enddate>201409</enddate><creator>Toomey, Paul</creator><creator>Teta, Anthony</creator><creator>Patel, Krishen</creator><creator>Ross, Sharona</creator><creator>Sukharamwala, Prashant</creator><creator>Rosemurgy, Alexander S</creator><general>SAGE PUBLICATIONS, INC</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7QL</scope><scope>7RV</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M2P</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>201409</creationdate><title>Transoral incisionless fundoplication: is it as safe and efficacious as a Nissen or Toupet fundoplication?</title><author>Toomey, Paul ; Teta, Anthony ; Patel, Krishen ; Ross, Sharona ; Sukharamwala, Prashant ; Rosemurgy, Alexander S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-95bf967a92b227d8f7404b1d760f64d23fbd72c531011e98bdd6df7cb36d82c23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>Body mass index</topic><topic>Case-Control Studies</topic><topic>Chest Pain - 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Academic</collection><jtitle>The American surgeon</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Toomey, Paul</au><au>Teta, Anthony</au><au>Patel, Krishen</au><au>Ross, Sharona</au><au>Sukharamwala, Prashant</au><au>Rosemurgy, Alexander S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Transoral incisionless fundoplication: is it as safe and efficacious as a Nissen or Toupet fundoplication?</atitle><jtitle>The American surgeon</jtitle><addtitle>Am Surg</addtitle><date>2014-09</date><risdate>2014</risdate><volume>80</volume><issue>9</issue><spage>860</spage><epage>867</epage><pages>860-867</pages><issn>0003-1348</issn><eissn>1555-9823</eissn><abstract>Transoral incisionless fundoplication (TIF) was U.S. Food and Drug Administration-approved in 2007 to treat gastroesophageal reflux disease (GERD), but comparative data are lacking. This study was undertaken to compare outcomes for patients with GERD undergoing TIF versus laparoscopic Nissen or Toupet fundoplications. We undertook a case-controlled study of three cohorts of 20 patients undergoing TIF or laparoscopic Nissen or Toupet fundoplications from 2010 to 2013 controlling for age, body mass index, and preoperative DeMeester scores. All patients were prospectively followed. Median data are reported. Patients undergoing TIF had significantly shorter operative times (in minutes: 71 vs 119 and 85, respectively, P < 0.001) and length of stay (in days: 1, 2, and 1, respectively, P < 0.001). No matter the approach, patients reported dramatic and similar reduction in symptom frequency and severity (e.g., heartburn 8 to 0, P < 0.05). At follow-up, 83 per cent of patients after TIF, 80 per cent after Nissen, or 92 per cent after Toupet fundoplications had symptoms less than once per month (P = 0.12). TIF leads to dramatic symptom resolution, similar when compared with Nissen or Toupet fundoplications. TIF promotes shorter operative times and lengths of stay. Patient satisfaction and effective palliation of symptoms show that TIF is safe and efficacious in comparison to Nissen and Toupet fundoplications and support its continued application and evaluation.</abstract><cop>United States</cop><pub>SAGE PUBLICATIONS, INC</pub><pmid>25197871</pmid><doi>10.1177/000313481408000918</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Body mass index Case-Control Studies Chest Pain - etiology Conversion to Open Surgery - statistics & numerical data Cough - etiology Deglutition Disorders - etiology Drug therapy FDA approval Feasibility Studies Female Follow-Up Studies Fundoplication - adverse effects Fundoplication - methods Gastroesophageal reflux Gastroesophageal Reflux - surgery Heartburn - etiology Humans Laparoscopy Laryngopharyngeal Reflux - etiology Length of Stay Male Middle Aged Minimally Invasive Surgical Procedures - adverse effects Minimally Invasive Surgical Procedures - methods Operative Time Osteoporosis Patient Satisfaction Patients Prospective Studies Treatment Outcome |
| title | Transoral incisionless fundoplication: is it as safe and efficacious as a Nissen or Toupet fundoplication? |
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