الفهرس 
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Abstract
Backgrond : GERD is very common disease with great negative impact on quality of life beside expenses of treatment, some patient need lifelong ppl treatment but they refuse to take medication for long period beside cumulative expenses and risk of long use of ppl, other GERD patient’s refuse surgery band risk of anesthesia, so these selected spectrum of patients are cancidate for endoscopic endoluminal treatment of GERD by applying radiofrequency to gastroesopohageal junction (stretta).
Study Aim : to assess the efficacy and safety of one and double dose of stretta in uncomplicated GERD and to compare it to sham stretta.
Patients and Methods : prospective trial where 30 patients (group A) underwent one session of stretta and the response monitored subjectively (by rate of off medications and by HRQL questionnaire) and objectively by measurement of LES resting pressure and acid exposure time by JDS at 0.2 and 6 months from the procedure , ( group c ) 10 patient ( subset of group A) underwent another session of stretta as they didn’t respond well to 1st session, sham stretta (group B) consist of 30 patients received 2 months of ppls and then evaluated like group A
Results 35% of group A stopped all kind of medication after 1 year from stretta and HRQL questionnaire showed significantly improvement after 1 year and symptomatology of GERD in the form of regurgitation and heartburn ar significantly improved, LES pressure significantly elevated from 10 mm Hg to about 13 mmHg, in spite the acid exposure time measured by (JDS) showed significantly improvement but still above normal value, group C showed further improvement in their HRQL and rate of off medications and regurgitation and heart burn incidence rate, however the LES pressure and acid exposure time improved but not significantly, about 80% of patients experienced relapse of symptoms after 1 year in group B and only 20% of patient stopped medication, no death or majore complications were reported in all stretta patients.
Conclusion : stretta considered safe endoscopic treatment of GERD with modest improvement and significantly superior to medical treatment, double sessions of stretta also considered safe and effective tool for patients whose not adequately respond to 1st session of stretta.
Key words: Stretta; radiofrequency to gastroesopohageal junction; endoscopic management of GERD.