title: Endoscopic full-thickness plication for the treatment of GERD: Five-year long-term multicenter results.
abstract: BACKGROUND
  The Plicator (NDO Surgical, Inc., Mansfield, MA) endoscopically places a full-thickness permanent suture to augment the antireflux barrier. At 3-years post-treatment, published results demonstrated a reduction in subjects' gastroesophageal reflux disease (GERD) symptoms and related medication use.
  
  
  OBJECTIVE
  To evaluate the Plicator's safety and durability of effect at improving GERD symptoms at 5-years post-treatment.
  
  
  METHODS
  A total of 33 chronic GERD sufferers across seven sites were followed for approximately 5 years (median follow-up: 59 months, range 50-65 months) after receiving a single full-thickness plication approximately 1 cm below the gastroesophageal (GE) junction in the anterior gastric cardia. At baseline, 30 out of 33 subjects required daily proton-pump inhibitor (PPI) therapy.
  
  
  RESULTS
  Of the subjects who were PPI dependent prior to treatment 67% (20/30) remained off daily PPI therapy at 60 months and 5-year median GERD health-related quality-of-life (HRQL) scores show significant improvement from baseline off-meds scores (10 versus 19, p < 0.001). Additionally, 50% (16/32) of subjects achieved >or= 50% score improvement in GERD-HRQL. No new adverse events were identified and all device-related events occurred acutely. These results were comparable to the results seen at 36 months follow-up.
  
  
  CONCLUSIONS
  Endoscopic full-thickness plication can reduce GERD symptoms and medication use for at least 5-years post procedure with no long-term adverse events post treatment.
authors.affiliation: Beth Israel Deaconess Medical Center, 330 Brookline Avenue, DA-501, Boston, MA 02215, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Pleskow
authors.forename: Richard
authors.initials: R
authors.lastname: Rothstein
authors.forename: Richard
authors.initials: R
authors.lastname: Kozarek
authors.forename: Gregory
authors.initials: G
authors.lastname: Haber
authors.forename: Christopher
authors.initials: C
authors.lastname: Gostout
authors.forename: Simon
authors.initials: S
authors.lastname: Lo
authors.forename: Robert
authors.initials: R
authors.lastname: Hawes
authors.forename: Anthony
authors.initials: A
authors.lastname: Lembo
mesh_terms: D000328:Adult; D000368:Aged; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors