ArticleSurgical endoscopy2014
Univariate and multivariate analyses of preoperative factors influencing symptomatic outcomes of transoral fundoplication.
Article in Surgical endoscopy, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 35 citations in OpenAlex.
- Fundoplication significantly improves objective and subjective reflux outcomes-a meta-analysis.Surgical endoscopy · 2025Pooled it
- Impact of second-generation transoral incisionless fundoplication on atypical GERD symptoms: a systematic review and meta-analysis.Gastrointestinal endoscopy · 2023Pooled it
- Efficacy and safety of transoral incisionless fundoplication in non-obese and obese adults: a population-based cohort study from the United States.Surgical endoscopy · 2026Article
- The Prevalence and Comorbidities of Self-Reported Mental Health Disorders Among Primary Healthcare Attendees in Riyadh, Saudi Arabia: A Cross-Sectional Survey.Healthcare (Basel, Switzerland) · 2026Article
- Therapeutic Management of Gastroesophageal Reflux Disease (GERD)-Is There Something Between PPI and Fundoplication? An Overview.Journal of clinical medicine · 2025Review
- Endoscopic Management of GERD.Digestive diseases and sciences · 2022Review
- Review
- Transoral incisionless fundoplication demonstrates durability at up to 9 years.Therapeutic advances in gastroenterology · 2021Article
- Transoral incisionless fundoplication with EsophyX for gastroesophageal reflux disease: clinical efficacy is maintained up to 10 years.Endoscopy international open · 2019Article
- Review of antireflux procedures for proton pump inhibitor nonresponsive gastroesophageal reflux disease.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2017Review
- Endoscopic Management of Gastroesophageal Reflux Disease: Revisited.Clinical endoscopy · 2016Review
- Endoscopic Options for Gastroesophageal Reflux: Where Are We Now and What Does the Future Hold?Current gastroenterology reports · 2016Review
- Transoral incisionless fundoplication: current status.Current opinion in gastroenterology · 2016Review
- Transoral incisionless fundoplication for gastro-esophageal reflux disease: Techniques and outcomes.World journal of gastrointestinal pharmacology and therapeutics · 2016Review
- Long-term efficacy of transoral incisionless fundoplication with Esophyx (Tif 2.0) and factors affecting outcomes in GERD patients followed for up to 6 years: a prospective single-center study.Surgical endoscopy · 2015Article
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Authors and funding
15 authors at 9 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPreoperative factors predicting symptomatic improvement after transoral fundoplication (TF) in chronic gastroesophageal reflux disease (GERD) patients with persistent symptoms on proton-pump inhibitors (PPIs) therapy have not been elucidated fully.
methodsUnivariate and multivariate logistic regression analyses were performed on data from 158 consecutive patients who underwent TF with the EsophyX device between January 2010 and June 2012 in 14 community centers. Variables included age, gender, body mass index, GERD duration, PPIs therapy duration, presence of hiatal hernia, esophagitis, Hill grade, quality of life scores (QOL) on PPIs, % total time pH < 4, and DeMeester score on reflux testing off PPIs.
resultsAll patients suffered from typical GERD symptoms. Additionally, 78% (124/158) of patients suffered from atypical symptoms. Six percent (10/158) with recurrent GERD symptoms refractory to PPI therapy underwent revisional procedure (9 laparoscopic Nissen, 1 TF). Median follow-up was 22 (range 10-43) months. For patients with typical symptoms, univariate analyses revealed 4 preoperative factors predictive of successful outcomes: age ≥ 50 [odds ratio (OR) = 2.4, 95% confidence interval (CI) = 1.2-4.8, p = 0.014], GERD Health-related Quality of Life score (GERD-HRQL) ≥ 15 on PPIs (OR = 6.0, CI = 1.2-29.4, p = 0.026, Reflux Symptom Index score > 13 on PPIs (OR = 2.4, CI = 1.1-5.2, p = 0.027), and Gastroesophageal Reflux Symptom Score ≥ 18 on PPIs (OR = 2.6, CI = 1.2-5.8, p = 0.018). Age and GERD-HRQL score remained significant predictors by multivariate analysis. For patients with atypical symptoms, only GERD-HRQL score ≥ 15 on PPIs (OR = 9.9, CI = 0.9-4.6, p = 0.036) was associated with successful outcomes.
conclusionsElevated preoperative QOL scores on PPIs and age ≥ 50 were most closely associated with successful outcome of TF in patients with persistent symptoms despite medical therapy.
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