A novel endoscopic submucosal dissection technique for proton pump inhibitor-refractory gastroesophageal reflux disease. (December 2014)

• Record Type: Journal Article
• Authors: Ota, Kazuhiro; Takeuchi, Toshihisa; Harada, Satoshi; Edogawa, Shoko; Kojima, Yuichi; Inoue, Takuya; Higuchi, Kazuhide
• Is Part Of: Scandinavian journal of gastroenterology. Volume 49:Number 12(2014)
• Page Start: 1409
• Page End: 1413
• Publication Date: 2014-12
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.3109/00365521.2014.978815
• Languages: English
• ISSNs: 0036-5521

Abstract

<abstract> <title>Abstract</title> <p> <bold> <italic>Objectives:</italic> </bold> Although drug treatment is the usual first-line therapy for gastroesophageal reflux disease (GERD), not all patients receive satisfactory relief from drug therapy, alone. We developed an endoscopic fundoplication technique using endoscopic submucosal dissection (ESD); the technique is referred to as ESD for GERD (ESD-G). This study investigated the safety and efficacy of this novel technique in patients with drug-refractory GERD. <bold><italic>Patients and methods:</italic></bold> ESD-G narrows the hiatal opening through ESD of the esophagogastric junction (EGJ) mucosa. For safety reasons, the range of mucosal resection was limited to half (1/2 or 1/4 +1/4) of the circumference of the EGJ lumen. ESD-G was performed on 13 patients with proton pump inhibitor (PPI)-refractory GERD. GERD symptoms, PPI dose, and 24-h esophageal pH monitoring results were compared before and 6 months after the procedure. <bold><italic>Results.</italic></bold> In 12 cases, symptoms significantly improved after ESD-G. Five patients demonstrated improved esophagitis, three were able to discontinue PPI therapy, and three were able to reduce their PPI dosage following surgery. The esophageal pH &lt;4 holding time ratio was also decreased after ESD-G. <bold><italic>Conclusions.</italic></bold> ESD-G may be useful for PPI-refractory GERD patients.</p> </abstract>