Radiofrequency energy delivery for gastro-esophageal reflux diseases

Objective To evaluate the safety and efficacy of Stretta procedure for gastro-esophageal reflux disease （GERD） based on changes of symptoms, medication and esophagitis grade. Methods A total of 90 patients with GERD who underwent Stretta procedure from June 2007 to March 2010 were followed up for 6 to 32 months. The health related quality of life of GERD （ GERD-HRQL）, symptoms, medication and grade of esophagitis were evaluated at baseline, 6 and 12 months after the procedure, respectively. Resuits GERD symptoms were significantly relieved after the treatment, with 63 patients （70. 0% ） showing obvious improvement in 2 months, 15（ 16. 7% ） being improved in 2 to 6 months, 8（8. 9% ） being relieved after 6 months, and 4（4.4% ） showing no changes. The mean GERD-HRQL scores was 25.6 at baseline, and decreased to 7.3 （ P 〈 0. 01 ） at 6 months） and 8.1 （ P 〈 0. 01 ） at 12 months. The mean heartburn scores was 3.3 at baseline and decreased to 1.2 at 12 months （P 〈0. 05）. Before Stretta procedure, only 31.1% of the patients were satisfied with symptom control by medication, which was increased to 86. 7% after treatment. The score of overall satisfaction with treatment improved from 1.4 at baseline to 4. 0 at 12 months after the procedure （ P 〈0. 01 ）. All patients needed proton pump inhibitors （PPIs） to control symptoms before the treatment, including 67.8% of patients who needed PPI combined with 2 other medicines or above, while at 6 months after the procedure, 76. 7% of patients were independent of PPI, or only accepted antacids or H2-receptor antagonists on demand. Out of 41 patients with erosive esophagitis before the procedure, 33（80. 5% ） showed normal esophagus at 6 months after the procedure, with 8 patients （19. 5% ） having reflux esophagitis of Grade A. Conclusion Stretta procedure can achieve significant improvements in symptom control and degree of esophagitis, it also can decrease the use of medicine. It is well tolerated, safe, effective and endurable for GERD patients. Key words: Gastroesophageal reflux ;  Radiofrequency ;  Therapy