{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:26:32Z","timestamp":1790717192332,"version":"4.1.0"},"reference-count":22,"publisher":"Georg Thieme Verlag KG","issue":"02","license":[{"start":{"date-parts":[[2021,2,3]],"date-time":"2021-02-03T00:00:00Z","timestamp":1612310400000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background and study aims\u2002Few reports exist about long-term outcomes of transoral incisionless fundoplication (TIF) for treating refractory gastro-esophageal reflux disease (GERD). <\/jats:p><jats:p>\n          Methods\u2002A literature search of four major scientific databases was performed up to May 2020 for studies reporting on more than 3-year outcomes of TIF. Data on atient satisfaction, proton pump inhibitor (PPI) daily consumption, PPI use reduction, GERD health-related quality-of-life (GERD-HRQL) score, and normalization of heartburn and regurgitation scores were pooled and summarized with forest plots. Publication bias and heterogeneity were explored.<\/jats:p><jats:p>\n          Results\u2002Overall, eight studies (418 patients, 232 men; 55.5\u200a%) with a mean follow-up of 5.3 years (range: 3\u201310 years) were included. The pooled proportion of patient-reported satisfaction before and after TIF was 12.3\u200a% (95\u200a% CI:12.3\u201335.1\u200a%, I2\u200a=\u200a87.4\u200a%) and 70.6\u200a% (95\u200a% CI:51.2\u201384.6, I2\u200a=\u200a80\u200a%), respectively, corresponding to an odds ratio of 21.4 (95\u200a% CI:3.27\u2013140.5). Pooled rates of patients completely off PPIs and on occasional PPIs were 53.8\u200a% (95\u200a%CI: 42.0\u200a%-65.1\u200a%) and 75.8\u200a% (95\u200a%CI: 67.6\u201382.6), respectively. The pooled estimated mean GERD-HRQL scores off PPI before and after TIF werey 26.1 (95\u200a%CI: 21.5\u201330.7; range: 20.0\u201335.5) and 5.9, respectively (95\u200a%CI:0.35.1\u201311.4; range: 5.3\u20139.8; P\u200a&lt;\u200a0.001). The overall pooled rates of heartburn and regurgitation scores normalization were 73.0\u200a% (95\u200a%CI: 0.62\u20130.82) and 86\u200a%, respectively (95\u200a%CI: 75.0\u201391.0\u200a%). <\/jats:p><jats:p>\n          Conclusion\u2002Our study shows that TIF appears to offer a long-term safe therapeutic option for selected patients with GERD who refuse life-long medical therapy or surgery, are intolerant to PPIs, or are at increased surgical risk.<\/jats:p>","DOI":"10.1055\/a-1322-2209","type":"journal-article","created":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T00:53:45Z","timestamp":1612400025000},"page":"E239-E246","source":"Crossref","is-referenced-by-count":60,"title":["Long-term outcomes of transoral incisionless fundoplication for gastro-esophageal reflux disease: systematic-review and meta-analysis"],"prefix":"10.1055","volume":"09","author":[{"given":"Sabrina","family":"Testoni","sequence":"first","affiliation":[{"name":"Division of Pancreatico-Biliary Endoscopy & Endosonography, Vita-Salute San Raffaele University, Scientific Institute San Raffaele, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Hassan","sequence":"first","affiliation":[{"name":"Ospedale Nuovo Regina Margherita, Digestive Endoscopy Unit, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Mazzoleni","sequence":"additional","affiliation":[{"name":"Ospedale di Treviglio \u2013 Caravaggio, ASST Bergamo Ovest, Digestive Endoscopy Unit, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulio","family":"Antonelli","sequence":"additional","affiliation":[{"name":"Ospedale Nuovo Regina Margherita, Digestive Endoscopy Unit, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorella","family":"Fanti","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Gastrointestinal Endoscopy, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandro","family":"Passaretti","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Gastrointestinal Endoscopy, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loredana","family":"Correale","sequence":"additional","affiliation":[{"name":"Im3D Clinic Piemonte S.c.a.r.l., Medical Imaging Lab, Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia Martina","family":"Cavestro","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology & Gastrointestinal Endoscopy, Vita-Salute San Raffaele University, San Raffaele Scientific Institute, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Alberto","family":"Testoni","sequence":"additional","affiliation":[{"name":"Division of 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