Endoluminal gastroplication for the treatment of gastroesophageal reflux disease: a 2-year prospective pilot study from Taiwan.
OBJECTIVE
Endoluminal gastroplication (ELGP) offers a minimally invasive option for the treatment of gastroesophageal reflux disease (GERD) in Western countries. However, long-term outcomes of ELGP in Asian populations have not been investigated. The aim of this prospective study was to evaluate the long-term benefits of ELGP in Asian patients with GERD.


METHODS
Taiwanese patients diagnosed with GERD were enrolled and had the procedure performed with EndoCinch. The assessment included symptom scoring, validated GERD questionnaires, esophagogastroduodenoscopy, esophageal manometry and 24-h pH monitoring before and after the procedure over a 2-year period.


RESULTS
Twenty-one consecutive patients were recruited and underwent ELGP. Patients reported improved heartburn symptom score (mean 64.0 vs 21.1, P < 0.001), regurgitation frequency score (mean 2.4 vs 1.3, P < 0.001), and GERD health-related quality of life (mean 23.1 vs 10.1, P < 0.001) at 24 months. The mean total time of pH < 4 reduced from 121.7 min to 67.1 min (P = 0.008) and mean DeMeester score reduced from 32.9 to 17.6 (P = 0.011) at 3 months. Antisecretory drug discontinuation rate was 81%, 57%, 52% and 48% at 1, 6, 12 and 24 months, respectively. Of the patients who had a favorable initial response to ELGP at 1 month, 41% resumed antisecretory medications at 24 months follow-up. All adverse events were mild and transient.


CONCLUSIONS
Endoluminal gastroplication is a safe and modestly effective endotherapy for patients with GERD. It significantly improved symptoms in an Asian population. Approximately one in two patients continues to be off medication at 24 months follow-up. However, the long-term efficacy and durability are still to be determined.
Liao
Chien-Chung
CC
Division of Gastroenterology, Department of Internal Medicine, Cathay General Hospital, Hsinchu, and School of Medicine, China Medical University, Taichung, Taiwan.
Lee
Chia-Long
CL
Lin
Bor-Ru
BR
Bai
Chyi-Huey
CH
Hsieh
Yu-Hsia
YH
Wu
Chi-Hwa
CH
Gostout
Christopher J
CJ
D000328:Adult; D000368:Aged; D016145:Endoscopy, Digestive System; D050782:Esophageal pH Monitoring; D004943:Esophagogastric Junction / Q000601:surgery*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D006356:Heartburn / Q000209:etiology / Q000517:prevention & control; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010865:Pilot Projects; D011446:Prospective Studies; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D011788:Quality of Life; D012720:Severity of Illness Index; D013536:Suture Techniques / Q000009:adverse effects / Q000295:instrumentation; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome
D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors