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 22 May 2018

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News

Endoscopic full-thickness plication for the treatment of GERD

This month's issue of Gastrointestinal Endoscopy finds that full-thickness plication at the gastroesophageal junction is an effective endoscopic procedure for treatment of patients with GERD and reduces reflux symptoms.

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Dr Lembo and colleagues assessed the intermediate- or 12 month term safety and efficacy of endoscopic full-thickness plication in patients with symptomatic gastroesophageal reflux disease (GERD).

The researchers included 64 patients with chronic heartburn that required maintenance antisecretory therapy.

The patients received a single, endoscopically placed, full-thickness plication in the gastric cardia 1 cm distal to the gastroesophageal junction.

At baseline and 12 months after plication, patients completed the GERD Health Related Quality of Life questionnaire, Gastrointestinal Symptom Rating Scale, and SF-36 Health Survey, as well as a medication use diary.

70 % of the patients who completed the follow-up were no longer taking a proton pump inhibitor
Gastrointestinal Endoscopy

The team obtained ambulatory 24 hour pH monitoring and esophageal manometry at baseline and 3 months after plication.

At 6 months after plication, the research team repeated the 24 hour pH study.

The investigators reported that of the 57 patients who completed the 12 month follow-up, 70 % were no longer taking a proton pump inhibitor.

The researchers found that the median GERD Health Related Quality of Life scores were improved compared with baseline, at 19 while taking medication and 13 while not taking medication.

The team demonstrated an improvement in distal esophageal acid exposure in 80 % of patients at 6 months after the procedure.

In addition, the researchers showed a decrease of 39 % in the median percentage of time where the pH was less than 4.

The team observed normal pH scores in 30 % of patients.

All procedure-related adverse events occurred acutely, as previously reported, and no new adverse event was observed during extended follow-up.

Dr Lembo concluded, “Full-thickness plication at the gastroesophageal junction is an effective endoscopic procedure for treatment of patients with symptoms caused by GERD.”

“It reduces reflux symptoms and antisecretory medication use over at least a 1 year period.”

Gastrointest Endosc 2005: 61(6): 643
04 May 2005

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