OBJECTIVE: To compare the short-term results of the radiofrequency treatment of the gastroesophageal junction known as the Stretta procedure versus @entity11035 ( @entity11035 ) in @entity1 with @entity354 ( @entity354 ). SUMMARY BACKGROUND DATA: The Stretta procedure has been shown to be safe, well tolerated, and highly effective in the treatment of @entity354 . METHODS: All @entity1 presenting to Vanderbilt University Medical Center for surgical evaluation of @entity354 between August 2000 and March 2002 were prospectively evaluated under an IRB-approved protocol. All @entity1 underwent esophageal motility testing and endoscopy that documented @entity354 preoperatively, either by a positive 24-hour pH study or biopsy-proven @entity2910 . @entity1 were offered the Stretta procedure if they had documented @entity354 and did not have a @entity357 larger than 2 cm, LES pressure less than 8 mmHg, or @entity355 . @entity1 with @entity357 , LES pressure less than 8 mmHg, or Barrett's were offered @entity11035 . All @entity1 were studied pre- and postoperatively with validated @entity354 -specific quality-of-life questionnaires (QOLRAD) and short-form health surveys (SF-12). Current medication use and satisfaction with the procedure was also obtained. RESULTS: Results are reported as mean +/- SEM. Seventy-five @entity1 (age 49 +/- 14 years, 44% male, 56% female) underwent @entity11035 and 65 @entity1 (age 46 +/- 12 years, 42%, 58% female) underwent the Stretta procedure. Preoperative esophageal acid exposure time was higher in the @entity11035 group. Preoperative LES pressure was higher in the Stretta group. In the @entity11035 group, 41% had large @entity357 (>2 cm), 8 @entity1 required Collis gastroplasty, 6 had @entity355 , and 10 had undergone previous fundoplication. At 6 months, the QOLRAD and SF-12 scores were significantly improved within both groups. There was an equal magnitude of improvement between pre- and postoperative QOLRAD and SF-12 scores between Stretta and @entity11035 @entity1 . Fifty-eight percent of Stretta @entity1 were off proton pump inhibitors, and an additional 31% had reduced their dose significantly; 97% of @entity11035 @entity1 were off PPIs. Twenty-two Stretta @entity1 returned for 24-hour pH testing at a mean of 7.2 +/- 0.5 months, and there was a significant reduction in esophageal acid exposure time. Both groups were highly satisfied with their procedure. CONCLUSIONS: The addition of a less invasive, endoscopic treatment for @entity354 to the surgical algorithm has allowed the authors to stratify the management of @entity354 @entity1 to treatment with either Stretta or @entity11035 according to size of @entity357 , LES pressure, @entity355 , and significant @entity358 . @entity1 undergoing Stretta are highly satisfied and have improved @entity354 symptoms and quality of life comparable to @entity11035 . The Stretta procedure is an effective alternative to @entity11035 in well-selected @entity1 .

Paradigm shift in the management of XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity355 :: ('MESH:D001471', 'Disease') :: ["Barrett's esophagus"] @entity2910 :: ('MESH:D004941', 'Disease') :: ['esophagitis'] @entity11035 :: ('MESH:C535647', 'Disease') :: ['LF', 'laparoscopic fundoplication'] @entity357 :: ('MESH:D006551', 'Disease') :: ['larger hiatal hernias', 'hiatal hernias', 'hiatal hernia'] @entity358 :: ('MESH:D008171', 'Disease') :: ['pulmonary symptoms'] @entity354 :: ('MESH:D005764', 'Disease') :: ['gastroesophageal reflux disease', 'GERD']
@entity354 :: (MESH:D005764,Disease) :: ['gastroesophageal reflux disease']
