A novel endoscopic full-thickness plication device has been developed to inhibit gastroesophageal reflux. It places a transmural plication near the gastroesophageal junction under direct endoscopic visualization.
In this study, doctors from North America assessed the safety and efficacy of endoscopic full-thickness plication for the treatment of GERD.
The team recruited patients with chronic heartburn requiring maintenance therapy with antisecretory medication.
They excluded patients with hiatal hernia (>2 cm), grade III and IV esophagitis, and Barrett's esophagus.
|PPIs were eliminated in 74% of patients.|
A total of 64 patients underwent a single, full-thickness plication in the gastric cardia just distal to the gastroesophageal junction.
Follow-up was 6 months. During this time the team evaluated health-related quality of life, GI symptoms, medication use, 24-hour esophageal pH, and esophageal manometry.
The doctors found that proton pump inhibitor use had been eliminated in 74% of patients by the end of follow-up.
In addition, they found that median GERD–Health-Related Quality of Life scores improved by 67%.
The team also noted improvement in the median Gastrointestinal Symptom Rating Scale and the SF-36 Health Survey mental and physical composite scores.
Furthermore, median esophageal acid exposure improved significantly. pH normalized in 30% of patients.
However, there was no significant change in esophageal manometry.
Overall, 1 gastric perforation occurred. This was managed conservatively without sequelae.
Dr Douglas Pleskow's team concluded, "In this study, a single full-thickness plication placed at the gastroesophageal junction reduced symptoms, medication use, and esophageal acid exposure associated with GERD".