Stretta as the initial antireflux procedure in children

Area of Science:

• Pediatric Gastroenterology
• Minimally Invasive Surgery
• Gastrointestinal Motility Disorders

Background:

• Gastroesophageal reflux disease (GERD) significantly impacts children's quality of life.
• The Stretta procedure, utilizing radiofrequency energy, is established for adult GERD but underreported in pediatric populations.
• This study introduces Stretta as an initial antireflux intervention for pediatric GERD.

Purpose of the Study:

• To evaluate the indications, safety, and efficacy of the Stretta procedure as a primary treatment for GERD in children.
• To assess Stretta's utility in pediatric patients, including those requiring concurrent feeding tube placement.

Main Methods:

• Retrospective review of 8 pediatric patients (11-16 years) who underwent the Stretta procedure.
• Patients were categorized into two groups: those with concomitant percutaneous gastrostomy tube placement (Group A) and those with isolated GERD (Group B).
• Preoperative GERD diagnosis and outcomes post-Stretta were analyzed.

Main Results:

• Stretta was successfully completed in all 8 pediatric patients.
• In Group A (n=3), all patients achieved GERD symptom resolution and tolerated full enteral nutrition.
• In Group B (n=5), 60% experienced symptom resolution and were off medication at short-term follow-up; one patient required subsequent Nissen fundoplication.

Conclusions:

• The Stretta procedure demonstrates safety and efficacy as an initial antireflux treatment for pediatric GERD.
• Combining Stretta with percutaneous endoscopic gastrostomy (PEG) is a viable option for children with GERD needing long-term feeding access.
• Further research with larger cohorts and longer follow-up is warranted to confirm these findings.