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DiscussionThe patients participating in this study population suffered from chronic severe GERD. Experienced more frequent and severe heartburn and acid reflux from GERD and EPI used daily dose of 20-80 mg for 6 years, most of the patients in 3 years. The high prevalence of hernia and gastritis, esophagitis reflects the advanced disease. Gastritis and gastric polyps have been associated with prolonged use of PPI [45-47]. Gastroscopy confirmed that at the same time with the presence of high acid exposure, hernia of esophageal, esophagitis and appeared impaired GE Union (class II or III of the Hill). Patients with similar characteristics are usually used for surgery backdraft [15, 17] referring to or with a dose of IPP [48, 49] treaties. The two experts in this study esophageal perforations were connected to a device. They emphasize pretherapeutic [23] the necessary attention to this point of trans-oral surgery [50] and the need for a careful evaluation of the patient. TIF, that have been made so far in the world were some 330 cases, only two known cases of esophageal injury during insertion of the device [51]. She could have been avoided, abnormal Anatomy or exceptionally narrow through the introduction of the operation carefully under endoscopic and continuous visualization exclude patients with cancer of the esophagus. A further development in the design of the device can also help to reduce this risk. Cases of bleeding in an intramural web partnership serious complication, only results directly on the method of planning and execution of procedures of TIF compression is probably the low incidence of intramural hemorrhage. The side effects were rare, mild and temporarily after the TIF procedure. Shoulder, 18% of the patients reported pain is usually associated with the laparoscopic anti-reflux and wine directly or indirectly an irritation of the phrenic nerve and the dermatome reply [52]. Abdominal pain reported in 15% of patients who most likely is derived from inflation during the procedure and Insufflation and procedures was proportional to the scale for the period. In 7% of patients with fixing serous epigastric pain was probably associated with transmural of. Faringolaringee pain, pain that radiates to the neck 8% of patients must be caused by the inclusion f 57 hoodia of 18 mm and repeated rotation around the longitudinal axis during the procedure. This nausea 7% of patients may be due, manipulation of anesthesia or tissue of blow at the intersection of GE, which finally showed that the wave of the nerve. 4% experienced postoperative dysphagia is the result of swelling at the intersection of GE and within 7 days without surgery. The side effects typically chronicle the fundoplication (such as dysphagia, gas, bloating, diarrhea) laparoscopic connected [19, 20 and 53] lack particular TIF. The difference in the incidence of these complications is probably due to the lack of any surgical preparation and curvature of the stomach into the esophagus capsules side effects observed [17, 20, 54] Nissen fundoplication contribute to. The results support the clinical efficacy of the TIF procedure after 12 months in the treatment of patients with chronic GERD. Improving overall median of GERD-rehabilitation of 68% at 12 months post-TIF revealed a complete resolution of symptoms in 75% of patients. Although the quality of life is subjective, in patients treated for heartburn, and not for their performance or looking for the abnormal esophagus [2, 3, 15] acid esophagitis. Although the reduction of symptoms of Gerd after 12 months, which corresponded to an IPP, TIF has brought a greater satisfaction of the patient PPI therapy. Deleting daily unit PPI in 85% of patients after 12 months after the intervention of EsophyX TIF also is encouraging. The TIF procedure shown be effective in the reduction of small hiatal hernia (≤ 2 cm). EsophyX has a trans-oral device can be identified such as reduction of small hiatal hernia [50]. The hypothesis that the sustainability of the hiatal hernia, Iris by reduction of TIF account Ernie was holding the Phrenoesophageal intrinsic components of the barrier backdraft [55, 56] was carried out. The reduction of small hiatal hernia TIF was sustainable in 60% of patients and contributed to the significant reduction of acid, the esophagus and esophagitis patients. Several studies have similar positive changes in the anatomy and physiology of the GE junction is displayed, after a hiatus, especially with regard to healing of esophagitis hernia, esophageal acid exposure standards and eliminated by increasing the pressure from other ERP [9-11]. Restoration of the damaged valve GE cross hills ends grade use Journal of PPI and healing of esophagitis in more than 80% of patients have taken to eliminate the symptoms of GERD, total. The efficiency achieved in 12 months for diabetics by valves 27% grade Hill was significantly correlated with reduction of hernia, normalization of the circumference of the Cardia and increased pressure in the rest. The correlation between the quality of reconstruction anatomical and improving results show clinical actions and physiopathological TIF provides convincing evidence for the ability of the process to improve competition of shooting at the intersection of GE. Although the exact valve total resolution of the bottom mechanism PFI examined, symptoms of GERD and reached in the majority of patients in this study, in particular those with the rank of a hill I have healing of esophagitis tracks they pointed out, that the TIF valves for better mechanical barrier had helped prevent GE reflux. Also sustainable and effective repair of small hiatal hernia, which has significantly increased resting, depleted Kardia pressure and had been restored at an acute angle capacity as TIF improve the competition of the barrier in the reflux. The fact that Ernie the preoperative hiatal hernia were smaller and less frequently in patients with the range of valves of a hill (44%), those with class II moderate valves Hill (67%), and grade III/IV (71%) the valve loose 12 months of Hill suggested that patients with small (≤ 2 cm) or not hiatal hernia is possibly the best top candidates for this procedure because have you seen the best results for the relief of symptoms of esophagitis and healing. The results of 12 months showed, has received the level of clinical and anatomical enhancements, while preserving the TIF with time. Technical expertise, the quality of the valve to measure, careful management of patients were the highest degree of anatomical repair of the intersection of GE TIF files factors as key. Similar factors have been successful anti [57-59] anti-reflux surgery. . . . . .