[GERD: endoscopic antireflux therapies].
A couple of minimally-invasive, endoscopic antireflux procedures have been developed during the last years. Beside endoscopic suturing these included injection/implantation technique of biopolymers and application of radiofrequency. Radiofrequency (Stretta) has proved only a very modest effect, while implantation techniques have been abandoned due to lack of long-term efficacy (Gatekeeper) or serious side effects (Enteryx). While first generation endoluminal suturing techniques (EndoCinch, ESD) demonstrated a proof of principle their lack of durability, due to suture loss, led to the development of a potentially durable transmural plication technique (Plicator). In a prospective-randomized, sham-controlled trial the Plicator procedure proved superiority concerning reflux symptoms, medication use and esophageal acid exposure (24-h-pH-metry). While long-term data have to be awaited to draw final conclusions, technical improvements will drive innovation in this field.
Caca
K
K
Medizinische Klinik I, Klinikum Ludwigsburg. Karel.Caca@kliniken-lb.de
D002299:Cardia / Q000601:surgery; D017115:Catheter Ablation; D002404:Catheterization; D016145:Endoscopy, Digestive System; D005500:Follow-Up Studies; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D013536:Suture Techniques; D016896:Treatment Outcome