Endoscopic Augmentation of the Lower Esophageal Sphincter for the Treatment of Gastroesophageal Reflux Disease: Multicenter Study of the Gatekeeper Reflux Repair System

Fockens, Paul; Bruno, M. J.; Gabbrielli, Armando; Ødegaard, Svein; Hatlebakk, Jan Gunnar; Allescher, H. D.; Rösch, Thomas; Rhodes, Michael; Bastid, C; Rey, Jean-Pierre; Boyer, J.; Muehldorffer, Stefan; Hombergh, Ubi van den; Costamagna, Guido

doi:10.1055/s-2004-825665

Cited by 93 publications

(62 citation statements)

References 16 publications

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“…Nach 6 Monaten gaben 7 von 9 Patienten (78%) eine Verbesserung der Refluxbeschwerden an. Nach 6 Monaten konnten 4 Patienten auf Protonenpumpenhemmer verzichten [11].…”

Section: Injektion Von Enteryx ®unclassified

Endoskopische Therapie der gastroösophagealen Refluxerkrankung

2002

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In der westlichen Welt leiden 8-10% der Bevölkerung häufig unter Symptomen einer gastroösophagealen Refluxerkrankung. Die Mehrzahl der Betroffenen wird durch eine Langzeittherapie mit Protonenpumpenhemmern beschwerdefrei. Viele Patienten wünschen jedoch eine Alternative zu einer oft lebenslangen Medikation, die selten auch noch mit Nebenwirkungen oder Unverträglichkeiten verbunden ist. Darüber hinaus belastet die medikamentöse Antirefluxtherapie die Ressourcen der westlichen Gesundheitssysteme mit mehreren Milliarden Euro pro Jahr. Die laparoskopische Fundoplikatio ist im Langzeitverlauf ähnlich effektiv und stellt für selektionierte Patienten zweifelsohne die bisher einzig sinnvolle Therapiealternative dar. Die Operation wird jedoch nur von weniger als 5% der Patienten in Anspruch genommen. Nebenwirkungen wie zumindest temporäre Dysphagie,Völlegefühl und Flatulenz sind häufiger.Vor diesem Hintergrund besteht ein erhebliches Interesse eines großen Patientenkollektivs an minimal invasiven Verfahren zur Antirefluxtherapie. In den letzten Jahren wurden eine Reihe unterschiedlicher endoluminaler Techniken entwickelt, die nachfolgend beschrieben und einer ersten Wertung unterzogen werden.

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“…Nach 6 Monaten gaben 7 von 9 Patienten (78%) eine Verbesserung der Refluxbeschwerden an. Nach 6 Monaten konnten 4 Patienten auf Protonenpumpenhemmer verzichten [11].…”

Section: Injektion Von Enteryx ®unclassified

Endoskopische Therapie der gastroösophagealen Refluxerkrankung

2002

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“…Preliminary results are quite encouraging and similar to the other endoscopic technologies. The device is currently undergoing clinical trial in anticipation of FDA approval [27].…”

Section: Types Of Endoscopic Therapies For Gerdmentioning

confidence: 99%

GERD: The Potential for Endoscopic Intervention

Triadafilopoulos¹

2004

Dig Dis

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Gastroesophageal reflux disease (GERD) is a common disorder that significantly affects patients’ quality of life. Most patients with symptomatic GERD do not have erosive reflux disease. Frequent transient lower oesophageal sphincter relaxations and the presence of hiatal hernia have emerged as major and interacting factors in GERD. Several endoscopic anti-reflux therapies aiming at creating an anti-reflux barrier and reducing or eliminating the need for chronic medical therapy or fundoplication have been introduced and validated as feasible, safe and effective. Today, it is possible to manage GERD patients with a multioption approach of medical, endoscopic or surgical therapies according to the size of hiatal hernia, the lower esophageal pressure profile and their clinical response to single-modality therapy.

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“…A study by Fockens et al [9] included 68 patients. The primary endpoints, GERD-HRQL and SF-36 score improved significantly; surprisingly, median acid exposure time was not improved at 3 months, but was improved at 6 months.…”

Section: The Gatekeepermentioning

confidence: 99%

“…The overtube is then rotated to unable to introduce another prosthesis at a different site. On average, 4 prostheses are delivered over 26.6 min [9]. …”

Section: The Gatekeepermentioning

confidence: 99%

Treatment of Gastroesophageal Reflux Disease: Endoscopic Aspects

Špičák

2007

Dig Dis

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Gastroesophageal reflux disease (GERD) is a very common chronic disorder manifesting itself as heartburn, regurgitation, or dysphagia, possibly leading to esophagitis, Barrett’s esophagus and adenocarcinoma, and has a major impact on the patient’s quality of life. Both medical treatment and surgery are well-established methods with several limitations. Recently, three types of endoscopic methods in several modifications have been developed: (1) Radiofrequency therapy (Stretta procedure) is available both in Europe and USA and more than 5,000 patients have been treated to date. (2) Injection therapy requires the injection of bulking agents or implantation of bioprosthesis into the lower esophageal sphincter (LES) zone. Both Enteryx was withdrawn from the market in 2005, and Gatekeeper was suspended before FDA approval. (3) Suturing/plication therapy is based on the plication at the level of the LES, and most of all techniques resemble the principle of surgical treatment. Despite sophisticated technologies and promising short-term results, all these techniques are associated with inconsistencies, controversies, and relevant adverse affects. According to current practice, use of endoscopic methods is justifiable only as part of clinical trials. Many aspects, including commercial ones, will influence future developments in this area, which are difficult to predict.

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Endoscopic Augmentation of the Lower Esophageal Sphincter for the Treatment of Gastroesophageal Reflux Disease: Multicenter Study of the Gatekeeper Reflux Repair System

Abstract: The Gatekeeper Reflux Repair System is a safe endoscopic treatment modality that significantly improves GERD symptoms and has objective effects on acid reflux.

Cited by 93 publications

References 16 publications

Endoskopische Therapie der gastroösophagealen Refluxerkrankung

Endoskopische Therapie der gastroösophagealen Refluxerkrankung

GERD: The Potential for Endoscopic Intervention

Treatment of Gastroesophageal Reflux Disease: Endoscopic Aspects

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