A new study led by the University of Oxford's Nuffield Department of Surgical Sciences is set to compare two surgical options for patients with gastro-oesophageal reflux disease (GORD), commonly known as acid reflux. The GOLF trial will evaluate the standard fundoplication procedure against the newer LINX procedure, aiming to provide clearer guidance on which surgery offers better long-term outcomes and fewer side effects.
Acid reflux can cause persistent heartburn, regurgitation, and discomfort that disrupts daily activities. When medications such as proton pump inhibitors are ineffective or result in adverse effects, surgery may be considered. Fundoplication, the current standard treatment, involves wrapping part of the stomach around the oesophagus to reinforce the valve between them. While this often prevents acid reflux, it can also lead to issues like bloating and difficulty burping.
The LINX procedure uses a ring of magnetic beads to support the same valve and has shown promise in reducing side effects. However, until now there has not been a large-scale direct comparison between LINX and fundoplication.
The GOLF trial will involve 460 patients from across the UK and Europe who have not responded to medication for GORD. Participants will be randomly assigned either LINX or fundoplication surgery. To maintain objectivity, neither patients nor outcome assessors will know which procedure was performed. Researchers will monitor results over two years.
Professor Sheraz R. Markar, Chief Investigator and Director of the Surgical Intervention Trials Unit at the University of Oxford, said: “This important international trial aims to improve the long-term health related quality of life for patients with gastro-oesophageal reflux disease through comparison of two established surgical treatments; fundoplication and the LINX procedure. We are hugely excited to undertake this trial and define the gold standard surgical treatment for gastro-oesophageal reflux disease.”
Mimi McCord, Chairman, Trustee and Director of Heartburn Cancer UK, commented: “This study is the first large project of its kind to see whether the LINX procedure will give patients fewer side effects compared to fundoplication. We hope that patients who have the LINX procedure will benefit from feeling less bloating and enables them to burp freely which can be distressing for those effected, but we need the GOLF study to test if this is the case or not. The study will ensure that we have the evidence to show which procedure - LINX or fundoplication - is best in helping to control acid reflux in patients. For patients who do not want to have surgery, or it has not successfully controlled their symptoms, this is an exciting step forward. I am delighted to be part of this study. It is a major step forward in ensuring patients get the best surgical treatment for their acid reflux.”
The GOLF trial receives funding from a partnership between National Institute for Health and Care Research (NIHR) and Medical Research Council (MRC). Details about participation are available on the Nuffield Department of Surgical Sciences website. The full protocol appears in the British Journal of Surgery.