Antireflux Mucosectomy. Preliminary Results of a Prospective Study

Ortega, A; Rosón, Pedro; Fernandez, F; Mellado-Romero, María Ángela; Aisa, M Angeles Perez; Cotta, J; Lozano, Michael

doi:10.1055/s-0039-1681893

Cited by 3 publications

(7 citation statements)

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“…In total, 331 patients from 12 studies underwent 335 ARMS procedures 10 11 12 18 19 20 21 22 23 24 25 26 , whereas 130 patients from three studies underwent 150 ARMA procedures 8 9 27 . Twenty-six patients underwent a second procedure: 4 underwent a second ARMS 10 12 , 20 underwent a second ARMA 9 , and 2 who failed ARMS were treated with ARMA 8 .…”

Section: Resultsmentioning

confidence: 99%

“…Twenty-six patients underwent a second procedure: 4 underwent a second ARMS 10 12 , 20 underwent a second ARMA 9 , and 2 who failed ARMS were treated with ARMA 8 . Eight studies were conducted in Asia 8 10 11 18 19 21 24 26 27 , four in Europe 12 20 23 25 , and three in North America 9 22 27 . Nine studies were reported as full-text publications 8 9 10 12 18 19 20 21 22 and six as conference abstracts 11 23 24 25 26 27 .…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies were conducted in Asia 8 10 11 18 19 21 24 26 27 , four in Europe 12 20 23 25 , and three in North America 9 22 27 . Nine studies were reported as full-text publications 8 9 10 12 18 19 20 21 22 and six as conference abstracts 11 23 24 25 26 27 . Fourteen studies were single-arm, and one study compared the outcomes of ARMS with those of patients who underwent LARS 22 .…”

Section: Resultsmentioning

confidence: 99%

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Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) for gastroesophageal reflux disease: a systematic review and meta-analysis

et al. 2021

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Background and study aims Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) are new endoscopic procedures for patients with gastroesophageal reflux disease (GERD). We conducted a meta-analysis to systematically assess the feasibility, clinical success, and safety of these procedures. Patients and methods We searched Embase, PubMed, and Cochrane Central from inception to October 2020. Overlapping reports, animal studies, and case reports were excluded. Our primary outcomes were clinical success and adverse events (AEs). Secondary outcomes included technical success, endoscopic esophagitis, 24-hour pH monitoring, and proton pump inhibitor (PPI) use. A random effects model was used to pool data. Results In total, 15 nonrandomized studies (12 ARMS, n = 331; 3 ARMA, n = 130) were included; 10 were conducted in patients with refractory GERD. The technical success rate was 100 %. The pooled short-term (first assessment within the first 6 months), 1-year, and 3-year clinical success rates were 78 % (95 % confidence interval [95 %CI] 70 %–85 %), 72% (95 %CI 47 %–92 %), and 73 % (95 %CI 65 %–81 %), respectively. ARMS and ARMA yielded similar clinical success. The proportion of patients off PPIs at 1 year was 64 % (95 %CI 52 %–75 %). There were significant drops (P < 0.01) in validated clinical questionnaires scores, presence of esophagitis, and acid exposure time. The most common AE (11 %, 95 %CI 8 %–15 %) was dysphagia requiring dilation (7%, 95 %CI 5 %–11 %). Four cases of perforation were recorded, all in patients undergoing ARMS. Conclusions Our meta-analysis of nonrandomized studies suggests that ARMS and ARMA are safe and effective for patients with GERD.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) for gastroesophageal reflux disease: a systematic review and meta-analysis

et al. 2021

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“…In total, 15 nonrandomized studies (12 on ARMS[ 69 - 72 , 74 , 77 - 83 ] and three on ARMA[ 75 , 76 , 84 ]) comprising 461 patients have evaluated the safety and effectiveness of these techniques (Tables 1 and 3 ). Follow-up ranged from 2 mo to a maximum of 3 years (in two studies[ 72 , 76 ]).…”

Section: Current Endoscopic Therapiesmentioning

confidence: 99%

“…Follow-up ranged from 2 mo to a maximum of 3 years (in two studies[ 72 , 76 ]). Clinical success ranged from 58% to 100% at 2-6 mo[ 81 , 83 ] and from 72% to 76% at 3 years[ 72 , 76 ]. Dysphagia was the most common adverse event, occurring in about 5% to 10% of the patients.…”

Section: Current Endoscopic Therapiesmentioning

confidence: 99%

Endoscopic anti-reflux therapy for gastroesophageal reflux disease

Santiago¹,

Albéniz²,

Estremera-Arévalo³

et al. 2021

WJG

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Gastroesophageal reflux disease has an increasing incidence and prevalence worldwide. A significant proportion of patients have a suboptimal response to proton pump inhibitors or are unwilling to take lifelong medication due to concerns about long-term adverse effects. Endoscopic anti-reflux therapies offer a minimally invasive option for patients unwilling to undergo surgical treatment or take lifelong medication. The best candidates are those with a good response to proton pump inhibitors and without a significant sliding hiatal hernia. Transoral incisionless fundoplication and nonablative radiofrequency are the techniques with the largest body of evidence and that have been tested in several randomized clinical trials. Band-assisted ligation techniques, anti-reflux mucosectomy, anti-reflux mucosal ablation, and new plication devices have yielded promising results in recent noncontrolled studies. Nonetheless, the role of endoscopic procedures remains controversial due to limited long-term and comparative data, and no consensus exists in current clinical guidelines. This review provides an updated summary focused on the patient selection, technical details, clinical success, and safety of current and future endoscopic anti-reflux techniques.

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Anti-reflux mucosectomy for refractory gastroesophageal reflux disease: a systematic review and meta-analysis

et al. 2022

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Background and study aims Anti-reflux mucosectomy (ARMS) is an emerging endoscopic treatment for refractory gastroesophageal reflux disease (GERD). We conducted a systematic review and meta-analysis to evaluate the safety and efficacy ARMS in refractory GERD. Methods A comprehensive search of multiple databases (through March 2020) was performed to identify studies that reported outcomes of ARMS for refractory GERD. Outcomes assessed included technical success, clinical response, and adverse events (AEs). Clinical response was defined as discontinuation (complete) or reduction (partial) of proton pump inhibitors post-ARMS at follow up. Results A total of 307 patients (mean age 46.9 [8.1] years, 41.5 % females) were included from 10 studies. The technical success and clinical response rates were 97.7 % (95 % confidence interval [CI], 94.6–99.0) and 80.1 % (95 % CI, 61.6–91.0), respectively. The pooled rate of complete and partial clinical response was 65.3 % (95 % CI, 51.4–77.0) and 21.5 % (95 % CI, 14.2–31.2), respectively. The rate of AEs was 17.2 % (95 % CI, 13.1–22.2) with most common AE being dysphagia/esophageal stricture followed by bleeding with rates of 11.4 % and 5.0 %, respectively. GERD health-related quality of life (GERD-HRQL) (mean difference [MD] = 14.9, P < 0.001), GERD questionnaire (GERD-Q) (MD = 4.85, P < 0.001) and mean acid exposure time (MD = 2.39, P = 0.01) decreased significantly post-ARMS as compared to pre-procedure. There was no difference in terms of clinical response and AEs between ARMS and ARMS with banding on subgroup analysis. Conclusions ARMS is a safe and effective procedure for treatment of refractory GERD with high rates of clinical response, acceptable safety profile and significant improvement in GERD-related quality of life. Prospective studies are needed to validate our findings.

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Antireflux Mucosectomy. Preliminary Results of a Prospective Study

Cited by 3 publications

References 0 publications

Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) for gastroesophageal reflux disease: a systematic review and meta-analysis

Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) for gastroesophageal reflux disease: a systematic review and meta-analysis

Endoscopic anti-reflux therapy for gastroesophageal reflux disease

Anti-reflux mucosectomy for refractory gastroesophageal reflux disease: a systematic review and meta-analysis

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