Gastroesophageal Reflux Disease Research Paper

1.0 Background
Gastroesophageal reflux disease (GERD) is a condition effected to LES (lower esophageal sphincter muscle that can cause various reflux symptom example burning sensation to chest and/or throat and If it is persistent in a long term, it might potential leading to adenocarcinoma of the esophagus.1 In generally, the initial treatment for this condition is medical therapy which provided to relieve acid reflux symptom, However, medical failure can occur in up to 20% of these patient 2,3 In GERD patient with failure Laparoscopic fundoplication is considered to be a standard surgical treatment of GERD4 Nevertheless, management of GERD following Sleeve gastrectomy (SG) in patient with medical refractory GERD is still
The Linx system is a laparoscopic procedure using a magnetic ring placed around the esophagus to augments weaken LES back into normal function. The previous study shows an effectiveness and safety of this device to performed in GERD patient.5 But this is still also having a risk of laparoscopic surgery and might be improperly in alternate anatomy like sleeve gastrectomy patient. Stretta procedure is an endoscopic option which less invasive by using Radio Frequency to the LES to induce fibrosis resulting increased LES pressure and multiple studies also show effectiveness in reducing Proton-pump inhibitor use and also improve the quality of
(Fig.2) The device contains with a deflatable balloon with a basket and four electrode needle sheath. The putative mechanism of Stretta focus on increase gastric yield pressure, increase thickness of LES muscle, decrease EG junction compliance without fibrosis, Decrease transient LES relaxations.10
The Stretta procedure will be performed according to the technique described by Triada lopoulos.11 At operating room, the patient was identified by name and operative procedure administrated with general endotracheal tube anesthesia, "the operation will start by diagnostic upper endoscopy to identify gastroesophageal junction, then the endoscope is pulled out, and the RF catheter is introduced over the guide-wire. The balloon of Stretta catheter will inflate at 2 cm proximal to EG junction. Then the electrode needle into the catheter will be deployed and applied radiofrequency energy for 60 seconds. The balloon is deflated, and the catheter will rotate about 45 degrees, then the process is repeated every 0.5 cm, covering an area of 2 cm above and 1.5 cm below EG junction for a total of 22 sets of needle deployments"11.