A long-term comparison of plication configurations for endoluminal gastroplication: circumferential versus helical.
OBJECTIVE
To determine the long-term efficacy of endoluminal gastroplication (ELGP) and the most effective plication configuration.


BACKGROUND
Endoluminal gastroplication is an intriguing therapy for gastroesophageal reflux disease. We conducted a retrospective review of a prospective experience of patient cohorts comparing outcomes of the circumferential and helical plication patterns.


METHODS
Twenty patients underwent ELGP, with 9 receiving the circumferential (Group 1) and 11 the helical pattern (Group 2). Manometry, endoscopy, and 24-hour pH monitoring were performed at baseline and at 6 months. Symptom scores and medication usage were assessed at baseline, 1, 3, 6, 12, and 18 months.


RESULTS
Both groups did not differ significantly from each other with respect to symptom improvement, medication usage, or other variables measured. At 6 months, symptom scores, histamine-2 receptor antagonist (H2RA), proton pump inhibitor usage, and hernia size decreased significantly. No other parameter showed a significant change. At the 18-month follow-up, symptom scores and H2RA usage decreased significantly.


CONCLUSIONS
ELGP improves heartburn and regurgitation scores at 18 months. Our study suggests that there is no benefit to additional plications when using the helical pattern.
Davis
Richard E
RE
Department of Surgery, Creighton University School of Medicine, 601 N. 30th Street, Omaha, NE 68131, USA.
Iqbal
Atif
A
Gerhardt
Janese D
JD
Welch
Rebecca A
RA
Turaga
Kiran
K
Tierney
Brent
B
Haider
Mumnoon
M
Filipi
Charles J
CJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000863:Antacids / Q000627:therapeutic use; D016099:Endoscopy, Gastrointestinal; D050782:Esophageal pH Monitoring; D004941:Esophagitis / Q000601:surgery; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery*; D006356:Heartburn / Q000601:surgery; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D054328:Proton Pump Inhibitors; D012189:Retrospective Studies; D040242:Risk Reduction Behavior; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D000863:Antacids; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors