Endoscopic implantation of Plexiglas (PMMA) microspheres for the treatment of GERD.
BACKGROUND
A gelatinous implant containing polymethylmethacrylate (PMMA) beads is successfully used to augment the diminished thickness of the chorium in patients with skin defects and wrinkles. The aim of the present study was to determine whether submucosal injection of PMMA microspheres into the lower esophageal folds decreases the severity of symptoms and acid reflux in patients with GERD.


METHODS
Endoscopic submucosal implantation of PMMA was carried out in 10 patients with GERD who were either refractory to or dependent on proton pump inhibitors. Symptom severity score, 24-hour pH monitoring, upper GI endoscopy, and EUS were performed to evaluate the efficacy of implantation.


RESULTS
A significant decrease in the symptom severity score and mean total time with esophageal pH less than 4 was noted after the implantation of PMMA (p < 0.05). Seven of 10 patients were taking no medication after PMMA implantation. There were no serious procedure-related complications.


CONCLUSIONS
Endoscopic implantation of PMMA into the submucosa of the lower esophageal folds may be a new method for treating GERD. Further studies are required to determine the long-term efficacy of the procedure.
Department of Therapeutic Endoscopy and the Department of Internal Medicine, "Hygeja" Hospital, Athens, Greece.
C
C
Feretis
P
P
Benakis
C
C
Dimopoulos
A
A
Dailianas
P
P
Filalithis
K M
KM
Stamou
A
A
Manouras
N
N
Apostolidis
D000328:Adult; D000368:Aged; D004945:Esophagoscopy / Q000379:methods*; D004947:Esophagus / Q000737:chemistry / Q000000981:diagnostic imaging; D005260:Female; D005764:Gastroesophageal Reflux / Q000628:therapy*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007279:Injections, Subcutaneous; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D019904:Polymethyl Methacrylate / Q000008:administration & dosage / Q000627:therapeutic use*; D014463:Ultrasonography
D019904:Polymethyl Methacrylate