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Success rates of anti-reflux surgeries

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Posted 10/7/2015 12:10 AM (GMT 0)
Does anyone know what the success rates of the various anti-reflux procedures and surgeries are?

So far I've been hearing mostly bad things about stretta and TIF and I've heard LNF is the gold standard but there seem to be a lot of people on here having issues with them which provides a skewed impression of how successful the surgery actually is. Obviously the stats are never going to be completely accurate, but if anyone could give an idea of what the success rate for any of these, as well as the toupet fundoplication and LINX that would be great. Also how common is it for someone to need a redo of a wrap?
Posted 10/7/2015 3:00 AM (GMT 0)
Satisfaction rates for the newer surgeries are getting better, not as good as the top rates for Nissen and its varieties, but you still have to ask about each individual surgeon or group. The group who did my Toupet claimed a rate around 95%, or so, and they did re-dos and cancer surgeries.

My surgeon operates as a team. They have a large practice, including residents and surgical fellows, and everyone gets to hold a retractor or something. I wouldn't go to a surgeon who thinks he can do a complicated Giant Paraesophageal Hiatal Hernia (GPEH), what I had, solo.

Some of these surgeries have to be done, partly at least, through the chest. My group are thoracic surgeons, not just general surgeons.

You have to find out what surgery is the one YOU need. My need was the Toupet because I have a "wimpy" swallow. Patients make awful doctors. Let your doctor tell you what you need, based on tests and type of problem you have.

So you see, it's not as simple as which surgery has the best outcomes.
Posted 10/7/2015 5:04 AM (GMT 0)
Oh I'm not asking to determine which surgery I want from the response that would be ludacris, its partly curiosity and partly so that when I next see my gastro I've got a bit more information when he makes his recommendations.
Posted 10/7/2015 5:18 AM (GMT 0)
Here is my understanding:
THEORETICALLY, Nissen and its varieties can fix any GERD with big Hiatal Hernia. Actually, the success rate varies widely between different centers.
Vomiting can disrupt the wrap. THEORETICALLY, it can be repaired or reversed, actually, it is extremely difficult and risky.

LINX: Most of patients off PPI(Still some ON PPI) after LINX. Will not work for patients with big Hiatal Hernia(> 3cm) or with swallow issue. Can not go MRI scan after LINX.

Endostim: Most of patients off PPI(Still some ON PPI) after Endostim. Will not work for patients with big Hiatal Hernia(> 3cm), no swallow issue. Can go most type of MRI after Endostim.

TIFF: It is done by endoscopy, the acid control is better than stretta, less than LINX or Endostim. If a patient has big Hiatal Hernia(> 3cm), he can fix Hiatal Hernia laparoscopically first, then perform TIF. It looks TIF has similar function as NISSEN for hernia, which is prevent the stomach going up again. The advantage of TIF is it is much safer, reversible. Compare with Nissen or partial fundo, it is a snack. If the acid control is not enough, he can implant endostim on top of TIFF, in this case, TIFF does not need to be reversed, there is always space there to implant Endostim.
TIF plus Endostim should fix very advanced gerd.

Stretta: I think Stretta is not powerful, however, after a failed NISSEN, some patients fix the gerd using Stretta, it looks the success rate is higher in the Nissen group for Stretta.

I am not a doctor, these are only my personal view.
Posted 10/7/2015 8:32 AM (GMT 0)
Don't know about stretta but NF is well over 90% and TIF is over 85% from what I've read. This is even in people with GERD refractory to PPIs
Posted 10/7/2015 9:31 PM (GMT 0)
Thanks guys that's interesting to hear.

What is endostim? I haven't heard of that one.

I saw an old newspaper article about a local lady who had a device implanted somewhere near her ribcage which was a trial treatment for reflux which at the time was looking pretty successful. I haven't heard anything further about implanted devices so I have no idea what it may be or if it even made it out of trials
Posted 10/8/2015 5:26 AM (GMT 0)
You can go to their website www.endostim.com. It is approved in Europe and the second generation already released, however, not approved in USA here, sooooo slow here in USA.

I know some patients in USA will fly to Europe to have the procedure done to avoid Nissen. The cost is about $17000 USA dollars in Germany, cheaper than other countries.
Posted 10/8/2015 6:57 AM (GMT 0)
Interesting, it looks like one of the teaching hospitals in a city about an hour from where I live does it. I have been wondering if I might be better off looking at the surgeons in Auckland, because the only options for surgeons who do anti-reflux where I live is general surgeons and bariatric surgeons.
Posted 10/8/2015 7:24 AM (GMT 0)
Hi jenagade, a GI in Auckland, Mr Booth, was involved in the NZ Endostim trials, his information should be on the Endostim website. I have spoken to that woman who was in the newspaper article.Her surgery was a success and she was off PPI's straight away. She has posted her story on this website. Type in Endostim in the search at the top and it will bring up her posts and others. I am going to investigate having this next year. It's not cheap, NZ$25,000, plus testing costs to see if you are suitable.
Posted 10/8/2015 8:27 AM (GMT 0)
Oh wow I didn't think there was anyone else from NZ on here! I'll have a look at her story, I came across it purely by chance while looking for information on the surgeons here in Hamilton.

I still have a way to go before I can look seriously at surgeries, my gastro admits that my options for medicinal treatment now are slim, but there is the road block that I have just had a cholecystectomy and my gastro is the cautious type.
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