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TIF demonstrates effectiveness for GERD symptoms

74% of patients were able to stop taking PPI medications at 12-months

Transoral Incisionless Fundoplication (TIF) is a safe and effective therapeutic option for carefully selected patients with chronic gastro-oesophageal reflux disease, according to the results of a registry published in the journal Surgical Laparoscopy Endoscopy and Percutaneous Techniques.

Data from the registry show that those quality-of-life scores remained the same or slightly improved over time, suggesting durability of outcomes between six- and 12-month follow-up. There were no major complications reported and oesophageal acid exposure was normalised in 14/27 (52%) of patients who underwent 12-month pH testing.

The one-year findings showed that 78 percent of patients experienced elimination of troublesome heartburn symptoms and 83 percent stopped experiencing regurgitation. Seventy-four percent of patients completely stopped medical therapy with proton pump inhibitor (PPI) medications, versus 92% on daily proton pump inhibitors before TIF (p<0.001).

“This data contributes significantly to the body of evidence that the TIF procedure is able to control troublesome symptoms of GERD patients for an extended period of time,” said Dr Erik B Wilson, Professor of Surgery at University of Texas Health Science Center and the first author of the publication. “When a procedure allows patients to significantly reduce or completely eliminate their use of PPI therapy, they can avoid a range of potential harmful long-term side effects.”

Median reflux symptom index score was reduced from 20 (0 to 41) to 5 (0 to 44), p<0.001. Two patients reported de novo dysphagia and one patient reported bloating (scores 0 to 3). Six patients underwent revision; five laparoscopic Nissen fundoplication and one TIF.

The aim of the registry study was to assess the impact of TIF on 100 consecutive patients with chronic GERD at 12-month follow-up.  Fourteen US centres, including 13 general surgery practices and one gastroenterology practice, were included in the study.

The TIF procedure uses the EsophyX device (EndoGastric Solutions) is to reconstruct the gastro-oesophageal valve, restoring its competency and re-establishing the barrier to reflux.

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