Data show that transoral incisionless fundoplication (TIF) may be an effective endoscopic treatment for gastroesophageal reflux (GER) occurring after peroral endoscopic myotomy (POEM) for achalasia. In a multicenter, retrospective study, researchers reported their results with post-POEM TIF for patients with GER. Study endpoints included technical success, safety, and effectiveness, as assessed by changes in symptoms, scores, proton pump inhibitor [PPI] use, and pH studies. Among 12 patients who had TIF after POEM, nine patients were experiencing daily symptoms, and 91.7% required twice-daily PPIs, prior to TIF. Technical success was attained in all patients, and only two adverse events occurred. Significant reductions occurred in the percentage of patients on twice-daily PPIs (P=0.03), rate of daily symptoms (P=0.03), Reflux Severity Index questionnaire (P=0.03), and GERD Health-related Quality of Life scores (P=0.003). In pH studies conducted in seven patients, results demonstrated a significant decline in the mean DeMeester score (P=0.05) and mean percentage acid exposure time (P=0.04).

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