{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:47:57Z","timestamp":1760921277541,"version":"build-2065373602"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Introduction: Transoral incisionless fundoplication (TIF) is a minimally invasive endoscopic procedure used for the management of gastroesophageal reflux disease (GERD) in patients with a hiatal hernia &amp;lt;&amp;gt;2 cm. Because TIF involves transmural fasteners placed across the gastroesophageal junction, there is a theoretical risk of vagal nerve injury leading to gastroparesis. Whether this risk differs from that seen with traditional anti-reflux surgery (ARS) remains unclear. Using the TriNetX multi-institutional database, we conducted a retrospective cohort study of adult patients with GERD who underwent either TIF or ARS. Patients with a prior history of gastroparesis or prior use of prokinetic agents were excluded. The primary outcome was the incidence of new-onset gastroparesis within 1 month to 1 year after the procedure; secondary outcome was the use of prokinetic agents. Propensity score matching was applied to balance baseline characteristics, including age, sex, race, BMI, diabetes, PPI, and opioid use. A total of 668 TIF and 53,996 ARS patients were identified. Before matching, gastroparesis incidence was similar between TIF (1.48%) and ARS (1.46%) (adjusted odds ratio [aOR] 1.01, 95% CI 0.54\u20131.9). After matching, the incidence remained comparable between TIF (0.7%) and ARS (1%) (aOR 1.0, 95% CI 0.22\u20132.26). The 1-year incidence of prokinetic agent use was lower in the TIF group (3.2%) than in the ARS group (6%) (aOR 0.51, 95% CI 0.3\u20130.9). In summary, post-surgical gastroparesis is rare after both TIF and ARS, with no significant difference between the two procedures. However, the need for prokinetic therapy was lower following TIF, suggesting a potentially lower burden of postoperative gastric motility symptoms. These findings may help guide counseling and individualized decision-making in GERD management.<\/jats:p>","DOI":"10.1093\/dote\/doaf087","type":"journal-article","created":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T17:50:00Z","timestamp":1760896200000},"source":"Crossref","is-referenced-by-count":0,"title":["Transoral incisionless fundoplication is not associated with higher rates of post-surgical gastroparesis compared to anti-reflux surgery for GERD"],"prefix":"10.1093","volume":"38","author":[{"given":"Fouad","family":"Jaber","sequence":"first","affiliation":[{"name":"Section of Gastroenterology, Hepatology & Nutrition, Baylor College of Medicine , Houston, TX ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brennan","family":"Gioe","sequence":"additional","affiliation":[{"name":"Department of Medicine, Baylor College of Medicine , Houston, TX ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kinan","family":"Obiedat","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Texas Medical Branch , Galveston, TX ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Jaber","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Rawalpindi Medical University , Rawalpindi, Punjab ,","place":["Pakistan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9776-1604","authenticated-orcid":false,"given":"Wasseem","family":"Skef","sequence":"additional","affiliation":[{"name":"Section of Endoluminal Surgery and Interventional Gastroenterology, McGovern Medical School at UTHealth Houston , Houston, TX ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wasif","family":"Abidi","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Hepatology & Nutrition, Baylor College of Medicine , Houston, TX ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalpesh","family":"Patel","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Hepatology & Nutrition, Baylor College of Medicine , Houston, TX ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fares","family":"Ayoub","sequence":"additional","affiliation":[{"name":"Section of Gastroenterology, Hepatology & Nutrition, Baylor College of Medicine , Houston, TX ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,10,19]]},"reference":[{"issue":"6","key":"2025101913495767900_ref1","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1136\/gutjnl-2012-304269","article-title":"Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review","volume":"63","author":"El-Serag","year":"2014","journal-title":"Gut"},{"issue":"1","key":"2025101913495767900_ref2","doi-asserted-by":"crossref","first-page":"13970","DOI":"10.1038\/s41598-023-41332-w","article-title":"Quality of life and severity of symptoms among patients with various degrees of reflux esophagitis: a prospective study","volume":"13","author":"Mari","year":"2023","journal-title":"Sci Rep"},{"issue":"3","key":"2025101913495767900_ref3","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/S0002-9343(97)00354-9","article-title":"The impact of gastroesophageal reflux disease on health-related quality of life","volume":"104","author":"Revicki","year":"1998","journal-title":"Am J Med"},{"issue":"1","key":"2025101913495767900_ref4","doi-asserted-by":"crossref","first-page":"27","DOI":"10.14309\/ajg.0000000000001538","article-title":"ACG clinical guideline for the diagnosis and Management of Gastroesophageal Reflux Disease","volume":"117","author":"Katz","year":"2022","journal-title":"Am J Gastroenterol"},{"issue":"5","key":"2025101913495767900_ref5","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1053\/j.gastro.2019.12.014","article-title":"Prevalence of gastroesophageal reflux disease and proton pump inhibitor-refractory symptoms","volume":"158","author":"Delshad","year":"2020","journal-title":"Gastroenterology"},{"issue":"4","key":"2025101913495767900_ref6","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1053\/j.gastro.2017.01.031","article-title":"The risks and benefits of long-term use of proton pump inhibitors: expert review and best practice advice from the American Gastroenterological Association","volume":"152","author":"Freedberg","year":"2017","journal-title":"Gastroenterology"},{"issue":"11\u201312","key":"2025101913495767900_ref7","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1111\/apt.13427","article-title":"Randomised clinical trial: transoral incisionless fundoplication vs. sham intervention to control chronic GERD","volume":"42","author":"H\u00e5kansson","year":"2015","journal-title":"Aliment Pharmacol Ther"},{"issue":"2","key":"2025101913495767900_ref8","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1053\/j.gastro.2014.10.009","article-title":"Efficacy of transoral fundoplication vs omeprazole for treatment of regurgitation in a randomized controlled trial","volume":"148","author":"Hunter","year":"2015","journal-title":"Gastroenterology"},{"issue":"2","key":"2025101913495767900_ref9","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1177\/1553350618755214","article-title":"The TEMPO trial at 5 years: Transoral fundoplication (TIF 2.0) is safe, durable, and cost-effective","volume":"25","author":"Trad","year":"2018","journal-title":"Surg Innov"},{"issue":"7","key":"2025101913495767900_ref10","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1055\/a-0576-6589","article-title":"Efficacy of transoral incisionless fundoplication for refractory gastroesophageal reflux disease: a systematic review and meta-analysis","volume":"50","author":"McCarty","year":"2018","journal-title":"Endoscopy"},{"issue":"3","key":"2025101913495767900_ref11","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1007\/s00464-016-5111-7","article-title":"Efficacy of transoral incisionless fundoplication (TIF) for the treatment of GERD: a systematic review with meta-analysis","volume":"31","author":"Huang","year":"2017","journal-title":"Surg Endosc"},{"issue":"3","key":"2025101913495767900_ref12","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1002\/bjs5.11","article-title":"Risk factors for delayed gastric emptying following laparoscopic repair of very large hiatus hernias","volume":"1","author":"Tog","year":"2017","journal-title":"BJS Open"},{"issue":"3","key":"2025101913495767900_ref13","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/S1091-255X(97)80113-8","article-title":"Complications of laparoscopic paraesophageal hernia repair","volume":"1","author":"Trus","year":"1997","journal-title":"J Gastrointest Surg"},{"issue":"1","key":"2025101913495767900_ref14","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.gie.2024.08.016","article-title":"Outcomes of transoral incisionless fundoplication (TIF 2.0): a prospective multicenter cohort study in academic and community gastroenterology and surgery practices (with video)","volume":"101","author":"Canto","year":"2025","journal-title":"Gastrointest Endosc"},{"issue":"4","key":"2025101913495767900_ref15","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1097\/MOG.0000000000000275","article-title":"Transoral incisionless fundoplication: current status","volume":"32","author":"Sami Trad","year":"2016","journal-title":"Curr Opin Gastroenterol"},{"issue":"10","key":"2025101913495767900_ref16","doi-asserted-by":"crossref","first-page":"3754","DOI":"10.1007\/s00464-013-2961-0","article-title":"Impact of transoral incisionless fundoplication (TIF) on subjective and objective GERD indices: a systematic review of the published literature","volume":"27","author":"Wendling","year":"2013","journal-title":"Surg Endosc"},{"issue":"9","key":"2025101913495767900_ref17","doi-asserted-by":"crossref","first-page":"2886","DOI":"10.1007\/s00464-018-6588-z","article-title":"Investigating rates of reoperation or postsurgical gastroparesis following fundoplication or paraesophageal hernia repair in New York state","volume":"33","author":"Lu","year":"2019","journal-title":"Surg Endosc"}],"container-title":["Diseases of the Esophagus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/38\/5\/doaf087\/64818183\/doaf087.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/38\/5\/doaf087\/64818183\/doaf087.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T17:50:03Z","timestamp":1760896203000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/dote\/article\/doi\/10.1093\/dote\/doaf087\/8293148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,9,1]]}},"URL":"https:\/\/doi.org\/10.1093\/dote\/doaf087","relation":{},"ISSN":["1120-8694","1442-2050"],"issn-type":[{"value":"1120-8694","type":"print"},{"value":"1442-2050","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,10]]},"published":{"date-parts":[[2025,9,1]]},"article-number":"doaf087"}}