SRS200 - Clinical outcomes of refluxstop procedure: systematic review and meta-analysis

Abstract Background Gastroesophageal reflux disease (GERD) is a chronic condition with multifactorial causes. Surgical interventions are gaining traction due to limitations of medical therapy. RefluxStop is a novel, minimally invasive technique designed to treat GERD without compressing the oesophagus. This is the first meta-analysis evaluating its clinical safety and efficacy. Methods A systematic review and meta-analysis were conducted, including all primary studies reporting clinical outcomes of RefluxStop. Results Out of 188 screened articles, six studies involving 336 patients were included. A majority (99.4%) underwent laparoscopic RefluxStop, with two conversions to open surgery. Preoperative dysphagia was noted in 27.9% of patients. GERD-HRQL scores were reported in five studies, though two used different scoring versions. Among 169 patients, the pooled preoperative mean GERD-HRQL score was 27.96, improving postoperatively to 3.89. The overall complication rate was 14.58%, with surgical emphysema being the most common (36.7% of complications). Device-related issues occurred in four patients, including migrations, slippage, and gastric penetration. Two cases were labelled as technical failures due to incorrect device placement. Twelve patients required further surgical or endoscopic management, and one experienced intraoperative oesophageal perforation. Patient satisfaction was high (95.5% in five studies), and two mortalities due to unrelated medical causes were reported. Conclusions RefluxStop shows promising improvement in GERD symptoms, with lower postoperative GERD-HRQL scores compared to magnetic sphincter augmentation (MSA) and fundoplication. However, it is associated with a higher complication rate (14.58%) and notable device-related issues, warranting further investigation for long-term safety and effectiveness.