Radiofrequency Energy Delivery To The Lower Esophageal Sphincter Reduces Esophageal Acid Exposure And Improves GERD Symptoms: A Systematic Review and Meta-Analysis.

Surgical Laparoscopy Endoscopy and Percutaneous Techniques, August 2012; 22(4) 283-288

INTRODUCTION: Studies of endoscopic application of radiofrequency energy to the lower esophageal sphincter for gastroesophageal reflux control have produced conflicting reports of its effectiveness.  This study aimed to conduct a meta-analysis of randomized controlled trials and cohort studies to assess the impact of the treatment. 

METHODS: Twenty studies were included. Outcomes analyzed included GERD symptom assessment, quality of life, esophageal pH, and esophageal manometry.
Results: A total of 1441 patients from 18 studies were included. Radiofrequency treatment improved heartburn scores (p=0.001), and produced improvements in quality of life as measured by GERD-HRQL scale (p=0.001) and QOLRAD (p=0.001). Esophageal acid exposure decreased from a pre-procedure Johnson-DeMeester score of 44.4 to 28.5 (p=0.007).

CONCLUSION: Radiofrequency ablation of the lower esophageal sphincter produces significant improvement in reflux symptoms and may represent an alternative to medical treatment and surgical fundoplication in select patients.