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Radiofrequency Energy Delivery to the Lower Esophageal Sphincter Reduces Esophageal Acid Exposure and Improves GERD Symptoms: A Systematic Review and Meta-analysis

Perry, Kyle A. MD; Banerjee, Ambar MD; Melvin, William Scott MD

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: August 2012 - Volume 22 - Issue 4 - p 283–288
doi: 10.1097/SLE.0b013e3182582e92
Special Section on Modern Approaches to the Treatment of Common Foregut Disease

Purpose: Studies of endoscopic application of radiofrequency energy to the lower esophageal sphincter for gastroesophageal reflux control have produced conflicting reports of its effectiveness. This study aimed to conduct a meta-analysis of randomized controlled trials and cohort studies to assess the impact of this treatment.

Methods: Twenty studies were included. Outcomes analyzed included gastroesophageal reflux disease (GERD) symptom assessment, quality of life, esophageal pH, and esophageal manometry.

Results: A total of 1441 patients from 18 studies were included. Radiofrequency treatment improved heartburn scores (P=0.001), and produced improvements in quality of life as measured by GERD–health-related quality-of-life scale (P=0.001) and quality of life in reflux and dyspepsia score (P=0.001). Esophageal acid exposure decreased from a preprocedure Johnson-DeMeester score of 44.4 to 28.5 (P=0.007).

Conclusions: Radiofrequency ablation of the lower esophageal sphincter produces significant improvement in reflux symptoms and may represent an alternative to medical treatment and surgical fundoplication in select patients.

Center for Minimally Invasive Surgery, Division of General and Gastrointestinal Surgery, The Ohio State University, Columbus, OH

Supported by an unrestricted research grant from Mederi Therapeutics Inc.

The authors declare no conflicts of interest.

Reprints: Kyle A. Perry, MD, Center for Minimally Invasive Surgery, Division of General and Gastrointestinal Surgery, N711 Doan Hall, 410 West 10th Avenue, Columbus, OH 43310 (e-mail: kyle.perry@osumc.edu).

Received March 29, 2012

Accepted March 30, 2012

© 2012 Lippincott Williams & Wilkins, Inc.