Gastrointestinal endoscopy · 2025
Comparing the feasibility, safety, and efficacy of Stretta radiofrequency and antireflux ablation therapy for treating patients with refractory gastroesophageal reflux disease: a retrospective, single-center cohort study.
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Lee Ah Young, Kim Seong Hwan, Cho Joo Young
Аннотация
BACKGROUND AND AIMS: This study compared Stretta radiofrequency (SRF) and antireflux ablation therapy (ARAT) using argon plasma coagulation for the treatment of refractory chronic GERD.
METHODS: The primary focus of this single-center retrospective cohort study involving 329 patients was the change in GERD questionnaire (GERDQ) scores. Secondary measures included Los Angeles (LA) classification, Hill's flap valve grade, proton pump inhibitor (PPI) discontinuation rate, Barrett's esophagus resolution rate, and incidence of adverse events. A subgroup analysis compared ARAT with two-thirds or full-width extent with multiple ARAT treatments and SRF, focusing on the primary outcomes.
RESULTS: There were no notable between-group differences in median GERDQ score changes; however, the SRF group exhibited a higher PPI withdrawal rate (P = .005). The ARAT group showed greater improvement in the median flap valve grade and resolution rate of Barrett's esophagus (P < .001). Comparing wider extent ablation in ARAT with SRF, symptom alleviation and PPI discontinuation rates were similar, but ARAT was superior in LA grade improvement with no increase in side effects (P < .001). Repeated ARAT treatments aligned more closely with SRF in terms of GERDQ score improvement.
CONCLUSIONS: Both groups showed similar improvements in GERDQ scores; however, SRF was more effective in terms of PPI withdrawal and caused fewer adverse events. In contrast, ARAT was better at improving Hill's valve grading and resolving Barrett's esophagus.
METHODS: The primary focus of this single-center retrospective cohort study involving 329 patients was the change in GERD questionnaire (GERDQ) scores. Secondary measures included Los Angeles (LA) classification, Hill's flap valve grade, proton pump inhibitor (PPI) discontinuation rate, Barrett's esophagus resolution rate, and incidence of adverse events. A subgroup analysis compared ARAT with two-thirds or full-width extent with multiple ARAT treatments and SRF, focusing on the primary outcomes.
RESULTS: There were no notable between-group differences in median GERDQ score changes; however, the SRF group exhibited a higher PPI withdrawal rate (P = .005). The ARAT group showed greater improvement in the median flap valve grade and resolution rate of Barrett's esophagus (P < .001). Comparing wider extent ablation in ARAT with SRF, symptom alleviation and PPI discontinuation rates were similar, but ARAT was superior in LA grade improvement with no increase in side effects (P < .001). Repeated ARAT treatments aligned more closely with SRF in terms of GERDQ score improvement.
CONCLUSIONS: Both groups showed similar improvements in GERDQ scores; however, SRF was more effective in terms of PPI withdrawal and caused fewer adverse events. In contrast, ARAT was better at improving Hill's valve grading and resolving Barrett's esophagus.