Anti-reflux mucosectomy using a cap-assisted endoscopic mucosal resection method for refractory gastroesophageal disease: a prospective feasibility study      
Yazarlar (9)
In Kyung Yoo
Weon Jin Ko
Hak Su Kim
Hee Kyung Kim
Jung Hyun Kim
Won Hee Kim
Sung Pyo Hong
Prof. Dr. Abdullah Özgür YENİOVA Tokat Gaziosmanpaşa Üniversitesi, Türkiye
Joo Young Cho
Makale Türü Özgün Makale
Makale Alt Türü SSCI, AHCI, SCI, SCI-Exp dergilerinde yayınlanan tam makale
Dergi Adı Surgical Endoscopy
Dergi ISSN 0930-2794 Wos Dergi Scopus Dergi
Dergi Tarandığı Indeksler SCI
Makale Dili İngilizce
Basım Tarihi 05-2019
Cilt No 34
Sayı 3
Sayfalar 1124 / 1131
DOI Numarası 10.1007/s00464-019-06859-y
Makale Linki http://link.springer.com/10.1007/s00464-019-06859-y
Özet
Background and aims: Endoscopic therapy of gastroesophageal reflux disease (GERD) overcomes the “treatment gap” for patients with refractory GERD, who are not willing to go into surgery. We propose an easy and efficient technique that is referred to as anti-reflux mucosectomy (ARMS) using cap-assisted endoscopic mucosal resection (EMR-C) which could be called ARMS-C. This study aimed to investigate the short-term outcomes of ARMS-C in GERD patients. Methods: From December 2016 to February 2018, we performed ARMS-C in 33 patients with pathologic reflux disease and esophageal hypersensitivity. ARMS-C involved endoscopic mucosal resection at the circumference of the esophagogastric junction (EGJ), resulting in narrowing of the hiatal opening after healing. The GERD symptoms, 24-h pH monitoring results, manometry, endoscopy, and EGJ distensibility were compared before and after the procedure. Results: Six months after ARMS-C, 63% of patients discontinued the use of pump inhibitors (PPIs), while 30% patients reduced their PPI dose. The GERD questionnaire scores significantly decreased after ARMS-C, from 11.0 to 6.0 (P < 0.001). The median DeMeester score and acid exposure time based on pH monitoring also improved after ARMS-C. Furthermore, the median flap valve grade and EGJ distensibility decreased from 3.0 to 1.0 (P < 0.001) and from 19.0 to 13.9 (P < 0.001), respectively. Two patients were treated with balloon dilation due to stricture, but no other serious adverse events were encountered. Conclusion: ARMS-C may be an effective and safe treatment method for GERD in terms of short-term outcomes.
Anahtar Kelimeler
Gastroesophageal reflux disease | Anti-reflux mucosectomy | Short-term outcomes | Cap-assisted endoscopic mucosal resection