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Recruiting NCT05781347

NCT05781347 Stretta Versus Conservative Treatment

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Clinical Trial Summary
NCT ID NCT05781347
Status Recruiting
Phase
Sponsor Military University Hospital, Prague
Condition GERD
Study Type INTERVENTIONAL
Enrollment 50 participants
Start Date 2022-09-01
Primary Completion 2026-01-01

Trial Parameters

Condition GERD
Sponsor Military University Hospital, Prague
Study Type INTERVENTIONAL
Phase N/A
Enrollment 50
Sex ALL
Min Age 18 Years
Max Age 70 Years
Start Date 2022-09-01
Completion 2026-01-01
Interventions
Radiofrequency Energy to the LES (Stretta Procedure)Stretta

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Brief Summary

Gastroesophageal reflux disease (GERD) is one of the most common diseases of the gastrointestinal tract. Obesity is a significant risk factor for GERD; however, treatment outcomes in obese patients remain challenging. In the Czech Republic, therapeutic options are currently limited to conservative treatment, including pharmacotherapy and lifestyle modifications, or surgical interventions, both of which have known limitations. Stretta is a minimally invasive endoscopic therapy using radiofrequency energy delivered to the esophagogastric junction (EGJ) and cardia, aimed at enhancing the antireflux barrier. This study evaluates the effectiveness and safety of the Stretta procedure compared to conservative treatment in managing GERD. Initially designed to compare outcomes between obese and non-obese populations, the study was expanded to include all GERD patients due to recruitment challenges and the need to meet strict eligibility criteria. These criteria ensure reliable results by focusing on patients with confirmed pathological GERD while excluding those with hiatal hernias ≥ 2 cm, severe esophagitis, or functional esophageal disorders such as hypersensitivity. The study aims to provide comprehensive data on the use of Stretta in the Czech Republic and its role in GERD management.

Eligibility Criteria

Inclusion Criteria: Verified symptomatic GERD despite PPI use, with persistent symptoms, desire to discontinue PPIs, or intolerance to them. Pathological gastroesophageal reflux confirmed by positive 24-hour pH-metry with impedance. Normal findings on high-resolution esophageal manometry (HRM) according to CCv4.0. Age ≥ 18 years. Signed informed consent for participation in the trial and invasive procedures. Exclusion Criteria: Active severe reflux esophagitis (Los Angeles classification grade C or D). Barrett's esophagus. Esophageal peptic stricture or eosinophilic esophagitis. Hiatal hernia ≥ 2 cm. Malignancies. Abnormal findings on high-resolution esophageal manometry. Esophageal or subcardial varices. Pregnancy. Severe comorbidities or increased perioperative risk. Age \> 70 years due to increased perioperative risk and common comorbidities. Symptoms primarily attributable to functional dyspepsia, significant anxiety, or depression, with overlap to other disorders of gut-brain inte

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