Abstract | BACKGROUND AND AIM: Anti-reflux mucosal ablation (ARMA) is an emerging endoscopic treatment aimed at enhancing the gastroesophageal junction flap valve. This study aimed to evaluate its feasibility, effectiveness, and safety. METHODS: Between May 2018 and December 2022, patients with gastroesophageal reflux disease ( GERD) symptoms refractory to acid suppression medications or those dependent on such medications were enrolled for ARMA. This retrospective analysis utilized prospectively collected data from an international bi-center study. GERD questionnaire, upper endoscopy, and 24-h pH monitoring were conducted at 2-6 months and 12 months post-ARMA. Clinical success was defined as a > 50% reduction in a validated GERD questionnaire. RESULTS: A total of 68 patients underwent ARMA. Definitive GERD was diagnosed in 44 (64.7%) patients, while 24 (35.3%) exhibited reflux hypersensitivity. Clinical success rates at 2-6 months and 1 year post-ARMA were 60% (39/65) and 70% (21/30), respectively. The median GERD-health-related quality of life score significantly improved from 26 to 11 at 2-6 months (P < 0.001). Among the 51 patients (71.8%) who underwent 24-h pH monitoring, the median acid exposure time decreased from 5.3% to 0.7% (P = 0.003), accompanied by a significant reduction in esophagitis rates (P < 0.001). Multivariate analysis did not identify predictors of short-term success. Nine (13.2%) patients experienced transient stenosis requiring balloon dilation. CONCLUSIONS: ARMA demonstrates both technical feasibility and reproducibility as a safe procedure that effectively ameliorates GERD symptoms in approximately two-thirds of patients during short-term follow up. Both reflux hypersensitivity and confirmed GERD patients, regardless of their response to acid suppression medication, may be suitable candidates.
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Authors | Yuto Shimamura, Haruhiro Inoue, Mayo Tanabe, Kei Ushikubo, Kazuki Yamamoto, Yoshiaki Kimoto, Yohei Nishikawa, Ryohei Ando, Kazuya Sumi, Marc Julius Navarro, Carlos Teruel Sanchez-Vegazo, Beatriz Peñas, Sofía Parejo, Alba Martínez Sánchez, Enrique Vazquez-Sequeiros, Manabu Onimaru, Agustín Albillos, Enrique Rodriguez de Santiago |
Journal | Journal of gastroenterology and hepatology
(J Gastroenterol Hepatol)
(Oct 03 2023)
ISSN: 1440-1746 [Electronic] Australia |
PMID | 37787176
(Publication Type: Journal Article)
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Copyright | © 2023 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. |