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Stretta Therapy

Ten-years of relief from GERD post-Stretta Therapy

After Stretta therapy, the refractory LNF subset demonstrated median improvements in GERD-HRQL, satisfaction, and medication use at all follow-up time points ≥6 months to ten years

A study published in Surgical Endoscopy, the journal of the Society of American Gastrointestinal and Endoscopic Surgeons has reported ten-year data showing the safety and efficacy of Stretta therapy in treating patients suffering from recurring GERD after the failure of anti-reflux surgery. Patients with uncontrolled GERD often undergo a surgical procedure called laparoscopic Nissen fundoplication (LNF) to treat their reflux. This involves wrapping the upper portion of the stomach around the oesophagus as a means to augment the sphincter and reduce reflux events. Although effective, LNF patients often suffer from long-term recurring GERD symptoms, requiring continuous use of medications or a reoperation. These options are not desirable for many patients and can come with significant complications.

These failed or relapsed patients may be candidates for Stretta Therapy, a non-surgical procedure that uses a transoral catheter device to deliver non-ablative radiofrequency energy to the lower oesophageal sphincter muscle, improving the barrier to reflux, and reducing GERD symptoms.

Mark Noar

"In this prospective study, we compared the ten-year follow-up data from patients who had Stretta after failed LNF with data from patients who had Stretta but did not have previous surgery. We found that Stretta patients who had previous LNF surgery experienced a sustained improvement of GERD symptoms equivalent to the standard Stretta patients. Stretta Therapy helps these patients control GERD and reduce chronic medication use without the need for a second LNF surgery,” said the study's lead author, Dr Mark Noar, director of The Heartburn and Reflux Study Center in Towson, MD.

Stretta is a transoral, non-surgical intervention that uses low power radiofrequency (RF) energy to remodel the muscle between the stomach and oesophagus. Studies demonstrate that Stretta resolves reflux symptoms, improves quality of life, reduces or eliminates medications, and decreases acid exposure in patients with chronic GERD.

Stretta therapy delivers low power, low temperature radiofrequency energy to remodel the valve known as the lower oesophageal sphincter (LES) at the junction of the oesophagus and the stomach. Stretta reduces or eliminates regurgitation of stomach contents by improving muscle tone and reducing random openings of the LES that are known to cause GERD. Stretta treatment results in elimination or significant reductions of GERD symptoms and medication use, and significant improvement in a patient's quality of life. (Credit: PRNewsFoto/Mederi Therapeutics Inc.)

The new study, ‘Radiofrequency energy delivery to the lower esophageal sphincter improves gastroesophageal reflux patient-reported outcomes in failed laparoscopic Nissen fundoplication cohort’, compared ten-year results of Stretta Therapy for refractory GERD patients in those who had failed previous LNF surgery, as well as those patients who had not had surgery.

After Stretta therapy, the refractory LNF subset demonstrated median improvements in GERD-HRQL, satisfaction, and medication use at all follow-up time points ≥6 months to ten years, which the researcher say was significant from a baseline of both on- and off-medications (p<0.05).

Specifically at ten years, median GERD-HRQL decreased from 36 to 7 (p<0.001), satisfaction increased from 1 to 4 (p<0.001), and medication score decreased from 7 to 6 (p=0.040). Nine patients decreased medication use by half at ten years. No significant differences existed between refractory LNF and standard refractory GERD subsets at any follow-up time point ≥6 months to ten years (p>0.05) after Stretta.

At ten years, no significant differences were noted between refractory LNF and standard Stretta subsets regarding medication use (p=0.088), patient satisfaction (p=0.573), and GERD-HRQL (p=0.075). Stretta procedures were completed without difficulty or significant intraoperative or long-term adverse events.

"Stretta effectively treats the underlying muscle without needing to wrap the stomach or perform other anatomical alteration, it should be considered first line treatment in patients who have failed Nissen,” added Noar.

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