A team from the USA investigated the use of transoral, flexible-endoscopic suturing for treatment of gastroesophageal reflux disease (GERD).
|Heartburn severity and frequency, and regurgitation, all improved.|
A multicenter trial was initiated that included 64 patients with GERD, treated with an endoscopic suturing device.
Inclusion criteria were 3 or more heartburn episodes per week while not taking medication, dependency on antisecretory medicine, and documented acid reflux by pH monitoring.
Exclusion criteria were dysphagia, Grade 3 or 4 esophagitis, obesity, and hiatus hernia greater than 2 cm in length.
Patients underwent manometry, endoscopy, 24-hour pH monitoring, and symptom severity scoring before and after the procedure. Patients were randomized to a linear or circumferential plication configuration. Adverse procedural events were recorded.
The researchers found that mean 6-month symptom score changes demonstrated procedural efficacy.
Heartburn severity and frequency as well as regurgitation all improved.
24-hour pH monitoring showed an improvement in number of episodes below a pH of 4, at 3 and 6 months, and the percentage of total time the pH was less than 4 at 6 months.
Plication configuration did not affect symptoms or pH monitoring results.
One patient had a self-contained suture perforation that was successfully treated with antibiotics.
Dr Charles J. Filipi, of Creighton University, Omaha, Nebraska, concluded from the research, "Endoscopic gastroplasty is safe. It is associated with reduced symptoms and medication use at 6-month follow-up in patients with uncomplicated GERD."