Vienna | Heidelberg, May 7 2014. Heartburn is caused by the reflux of gastric acid into the esophagus. Around 30 to 40 percent of the population suffers from gastroesophageal reflux disease, and treatment using drugs or surgery has had limited success to date. In light of a new method using electrostimulation, the Cologne-based surgeon Professor Ernst Eypasch and his team focused on the world’s first multicenter study results. The results will be published for the first time mid-May in the Springer journal European Surgery 02/14.

The principle of the new method is based on electrostimulation by strengthening the lower esophageal sphincter, which acts as an anti-reflux valve to prevent the reflux of gastric acid in solid, liquid, or gaseous form into the esophagus. During a surgical procedure lasting around an hour, two electrodes are implanted at the exit of the esophagus and linked to a pulse generator by a lead. The generator is implanted under the skin in the left upper abdomen and supplied with power by a battery the size of a matchbox. The electrodes stimulate the sphincter, thus eliminating symptoms such as heartburn and regurgitation. In addition, most patients no longer require gastric acid-blocking medication.

The advantage of the innovative and minimally invasive stimulation method is that it can be individually adjusted depending on the effect. Patients can eat and drink normally immediately after the operation and can be discharged from hospital the following day. The method has been used so far in patients with early-stage reflux disease with a small diaphragmatic hernia, which was also corrected. “Initial results in 60 patients six months to two years after the procedure are comparable with those of conventional anti-reflux operations,” said Prof. Eypasch.
Patience is called for, however: “It is certainly still too early to judge the true value of the method in treating reflux; we simply don’t have the numbers,” explained Prof. Sebastian F. Schoppmann, a surgeon at the Medical University of Vienna’s University Surgical Hospital.
“At the moment, the method should therefore only be used as part of academic clinical studies in specialist centers geared toward them.” Preparations are currently being made to use this method in Austria.
“I hope that the scientific publication will help support the method’s introduction not only in Germany and Austria, but also at international level,” said the Vienna-based surgeon Prof. Martin Riegler, editor of European Surgery.

Conservative treatment with a gastric acid blocker is initially effective, but becomes less effective within a year in more than half the patients, meaning that symptoms recur. In addition to medication, surgical procedures also need to be considered. They allow the sphincter to be repaired mechanically. Part of the stomach or a magnetic ring is wrapped around the exit to the esophagus. These operations are performed using keyhole surgery (laparoscopy) , but it takes five to ten years to achieve a patient satisfaction rate of 80 to 90 per cent.

Journalists can download the full text ‘Electrical stimulation of the lower oesophageal sphincter: an emerging therapy for treatment of GORD‘, published in European Surgery 02/14, free of charge.

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