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Radiofrequency Energy Delivery to the Lower Esophageal Sphincter (Stretta Procedure) Does Not Provide Long-term Symptom Control

Center for Minimally Invasive Surgery, Department of Surgery, The Ohio State University, Columbus

Steven S. Davis, MD

Center for Minimally Invasive Surgery, Department of Surgery, The Ohio State University, Columbus

Jeffrey W. Hazey, MD

Center for Minimally Invasive Surgery, Department of Surgery, The Ohio State University, Columbus

Vimal Narula, MD

Center for Minimally Invasive Surgery, Department of Surgery, The Ohio State University, Columbus

Peter Muscarella, MD

Center for Minimally Invasive Surgery, Department of Surgery, The Ohio State University, Columbus

William Scott Melvin, MD

Center for Minimally Invasive Surgery, Department of Surgery, The Ohio State University, Columbus, scott.melvin{at}osumc.edu

The Stretta procedure (radiofrequency energy application to the lower esophageal sphincter) is a unique endoluminal technique for the management of gastroesophageal reflux. This article reports on the long-term effectiveness of the Stretta procedure in patients with significant gastroesophageal reflux disease (GERD) referred to a surgical practice. Patients who underwent Stretta with a minimum of 36 months follow-up were included. Thirty-two patients with an average follow-up of 53 months were included; 19 proceeded to anti-reflux surgery. Those not undergoing surgery showed a significant improvement in their GERD satisfaction from 3.14 to 1.46 (P = .0006) but had significantly lower preprocedure heartburn scores (2.43) than those who proceeded to surgery (3.66, P = .0401). The Stretta procedure was effective in reducing symptoms in 40% of patients. Responders had less severe preoperative heartburn. Radiofrequency energy delivery to the lower esophageal sphincter may be effective in selected patients for the treatment of gastroesophageal reflux.

Key Words: gastroesophageal reflux disease • heartburn • Stretta procedure

This version was published on December 1, 2008

Surgical Innovation, Vol. 15, No. 4, 297-301 (2008)
DOI: 10.1177/1553350608324508


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