Short-term and long-term outcome of endoluminal gastroplication for the treatment of GERD: the first multicenter trial in Japan.
OBJECTIVE
Endoluminal gastroplication (ELGP) was the first endoscopic therapy for gastroesophageal reflux disease (GERD). Data on the long-term outcomes, including the plication status and data from Asian populations, are limited. The aim of this study was to evaluate the short-term and long-term effectiveness and safety of ELGP for GERD in the Japanese population.


METHODS
This was an open-label, prospective, multicenter trial of ELGP. Forty-eight patients with GERD were enrolled. The procedure involved placing circumferential plications 1-2 cm below the GE junction using the EndoCinch system. Outcome measurements were improvement of heartburn, medication use, endoscopic Los Angeles grade, durability of plications, 24-h esophageal acid exposure, esophageal manometry, and frequency of adverse events.


RESULTS
During the 24-month follow-up, the rate of complete resolution of heartburn ranged from 54 to 66%, the rate of discontinuation or reduction of PPI/H2RA use ranged from 65 to 76%, and the rate of endoscopic classification to grade O ranged from 66 to 81%. The status with more than one plication remaining was associated with higher rates of improvement of heartburn, PPI/H2RA use, and endoscopic findings as compared with those associated with the loss of all plications. A modest decrease of the esophageal acid exposure level, but no change of the manometric parameters, was observed after ELGP. No serious adverse events were observed.


CONCLUSIONS
In this 24-month follow-up study conducted in Japanese subjects, ELGP was found to be effective in about 60% of patients with GERD, and the procedure was safe.
Department of General and Gastrointestinal Surgery, School of Medicine, Fujita Health University, 3-6-10 Otobashi, Nakagawa-ku, Nagoya, Aichi, 454-8509, Japan. sozawa@fujita-hu.ac.jp
Soji
S
Ozawa
Koichiro
K
Kumai
Kazuhide
K
Higuchi
Tetsuo
T
Arakawa
Mototsugu
M
Kato
Masahiro
M
Asaka
Natsuya
N
Katada
Hiroyuki
H
Kuwano
Masaki
M
Kitajima
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016145:Endoscopy, Digestive System; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006356:Heartburn / Q000175:diagnosis; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016896:Treatment Outcome