S957 Efficacy of the Stretta Procedure at Treating Gastroesophageal Reflux Disease: A Single Center Study

Introduction: The treatment options for gastroesophageal reflux disease (GERD) include medications, surgery, and newer endoscopic treatments such as the Stretta procedure (Restech; Houston, TX), which administers radiofrequency ablation to augment the lower esophageal sphincter (LES) function. This study aims to retrospectively evaluate the Stretta procedure’s effectiveness at treating GERD at a large, academic medical center. Methods: A retrospective chart review was conducted for 78 patients that underwent the Stretta procedure at a single academic medical center from January 2019 to April 2024. For each patient, we abstracted data from their past medical and surgical history, medications, and any quality-of-life surveys that they completed pre-Stretta. Additionally, we recorded patient-reported symptoms and results of diagnostic testing completed before and after the Stretta procedure. Results: The mean age of the cohort was 51.5 ± 12.9 years. Nine out of 78 (11.5%) patients had gastroparesis, 41/78 (52.6%) had a hiatal hernia generally 2 cm or less, and 29/78 (37.2%) had body mass index ≥30. Of the 47/78 (60.3%) patients who were administered the Gastroesophageal Reflux Disease Questionnaire survey prior to Stretta, mean score was 10.8 ± 3.1 (out of 18), with 40/47 (85.1%) scoring ≥8. We identified 13/78 (16.7%) patients for whom we could compare the results of pre- and post-Stretta esophageal acid exposure testing (pH-impedance and/or Bravo). For testing completed on acid-suppressive medications (N = 9), a paired t test showed a significant increase in esophageal acid exposure time (mean: +5.5%; P = 0.030) after Stretta. For testing completed off medications (N = 4), a paired t test showed a significant decrease in acid exposure time (mean: -3.2%; P = 0.027) after Stretta. Changes in DeMeester score were insignificant. Of the 77/78 (98.7%) patients taking proton pump inhibitors (PPIs) after Stretta, 14/77 (18.2%) completely weaned off. Finally, 61/78 (78.2%) patients reported some level of GERD symptom improvement after Stretta. Conclusion: The effect of the Stretta procedure on acid exposure time varied by whether testing was done on vs off acid-suppressive medications. Patients’ ability to wean off medications post-Stretta (especially PPIs) was limited. Nevertheless, most patients reported some symptom improvement after the procedure, suggesting therapeutic value from the procedure. These results should be interpreted within the constraints of a small sample size and variability in the length of time elapsed between pre- and post-Stretta testing.