Radiofrequency ablation is safe and effective in the treatment of Chinese patients with gastroesophageal reflux disease: A single‐center prospective study

Liu, Pei Pei; Meng, Qian Qian; Han, Lin; Yao, Han; Qian, Wei; Li, Zhao Shen; Wang, Luo-Wei

doi:10.1111/1751-2980.12722

Cited by 6 publications

(7 citation statements)

References 32 publications

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“…In addition, improvement in satisfaction was evident at 3 mo after the procedure and was sustained over the entire observational period of 1 year. In agreement with most previous studies on reflux diseases [ 7 , 16 ], we also found that radiofrequency ablation significantly changed PPI usage in reflux hypersensitivity patients, as 86% patients used half-dose PPI or even discontinued treatment 12 mo after radiofrequency ablation, with only 3 patients still requiring the regular or higher dose to control refractory symptoms.…”

Section: Discussionsupporting

confidence: 92%

Efficacy of Endoscopic Radiofrequency Ablation for Treatment of Reflux Hypersensitivity: A Study Based on Rome IV Criteria

Jiang

Dong

Wang

et al. 2022

Gastroenterology Research and Practice

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Objective. Effective therapies for reflux hypersensitivity are lacking. Endoscopic radiofrequency ablation may reduce the sensitivity of the distal esophagus through direct interference with nociceptors or vagal afferent fibers and thus may be useful in reflux hypersensitivity. The aim of this study is to assess the effectiveness and possible mechanisms of endoscopic radiofrequency ablation in reflux hypersensitivity patients. Methods. Patients with reflux hypersensitivity who fulfilled the Rome IV criteria and who wished to receive further treatment were recruited. Endoscopic radiofrequency ablation was delivered to the gastroesophageal junction. Data were collected by questionnaire using a 6-point Likert scale. The primary outcome measure was effect on symptoms including heartburn, regurgitation, and chest pain. The secondary outcomes were degree of satisfaction, medication use, acid exposure time (AET), low esophageal sphincter (LES) pressure, and total reflux episodes. We also assessed positive cell density of transient receptor potential vanilloid type 1 receptor (TRPV1) and calcitonin gene-related peptide (CGRP), both of which are biomarkers of afferent fibers, in biopsies obtained from esophageal mucosa 0.5 cm-1 cm above the Z line. These scales will be administered at baseline, 3-month follow-up, 6-month follow-up, and 12-month follow-up. Results. A total of 22 reflux hypersensitivity patients were enrolled (14 males, median age 50.0 years). A significant improvement in symptom scores (heartburn, regurgitation, and chest pain) was noted at 3 months, 6 months, and 12 months ( P < 0.001 ). Satisfaction with life increased to 72.7% (16/22), 72.7% (16/22), and 68.2% (15/22) at 3, 6, and 12 mo, respectively, compared with baseline ( P < 0.001 ). Nineteen patients reduced their medication use after treatment. Of these, 22.7% (5/22), 31.8% (7/22), and 40.9% (9/22) subjects stopped medication use at 3 mo, 6 mo, and 12 mo, respectively. No statistical differences were noted in AET, LES pressure, or total reflux episodes from preoperation to 12 mo postoperation. After treatment, the positive cell density of both TRPV1 and CGRP decreased significantly; however, only TRPV1 had a positive correlation with heartburn ( r = 0.51 , P = 0.03 ) and chest pain ( r = 0.77 , P < 0.01 ). Conclusion. Endoscopic radiofrequency ablation was an effective and safe therapeutic option in reflux hypersensitivity patients. Further studies with large sample size are required to validate the role of radiofrequency in reflux hypersensitivity.

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Section: Discussionsupporting

confidence: 92%

Efficacy of Endoscopic Radiofrequency Ablation for Treatment of Reflux Hypersensitivity: A Study Based on Rome IV Criteria

Jiang

Dong

Wang

et al. 2022

Gastroenterology Research and Practice

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“…For Non-SAEs, although sore throats occurred in approximately 46.2% (95% CI: 39.6%–52.9%) of patients after RF ablation, the majority of patients had self-limiting and mild symptoms that resolved on their own without the need for surgery. Particularly, Liu et al [ 45 ] demonstrated that 27 patients had a 100% probability of developing sore throat after RF ablation treatment. In another study, [ 50 ] 37 out of 50 patients with rGERD experienced discomfort, such as sore throat after RF ablation treatment, which had a large impact on the incidence of adverse reactions in the RF group.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of endoscopic cardia peripheral tissue scar formation (ECSF) for the treatment of refractory gastroesophageal reflux disease: A systematic review with meta-analysis

Shi,

ZhuoMa,

Ying

et al. 2024

Medicine

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Background: Endoscopic treatment is increasingly used for refractory gastroesophageal reflux disease (rGERD). Unlike the mechanism of conventional surgical fundoplication, gastroesophageal junction ligation, anti-reflux mucosal intervention, and radiofrequency ablation have extremely similar anti-reflux mechanisms; hence, we collectively refer to them as endoscopic cardia peripheral tissue scar formation (ECSF). We conducted a systematic review and meta-analysis to assess the safety and efficacy of ECSF in treating rGERD. Methods: We performed a comprehensive search of several databases, including PubMed, Embase, Medline, China Knowledge Network, and Wanfang, to ensure a systematic approach for data collection between January 2011 and July 2023. Forest plots were used to summarize and combine the GERD-health-related quality of life (HRQL), gastroesophageal reflux questionnaire score, and DeMeester scores, acid exposure time, lower esophageal sphincter pressure, esophagitis, proton pump inhibitors use, and patient satisfaction. Results: This study comprised 37 studies, including 1732 patients. After ECSF, significant improvement in gastroesophageal reflux disease health-related quality of life score (mean difference [MD] = 18.27 95% CI: 14.81–21.74), gastroesophageal reflux questionnaire score (MD = 4.85 95% CI: 3.96–5.75), DeMeester score (MD = 42.34, 95% CI: 31.37–53.30), acid exposure time (MD = 7.98, 95% CI: 6.03–9.92), and lower esophageal sphincter pressure was observed (MD = −5.01, 95% CI: −8.39 to 1.62). The incidence of serious adverse effects after ECSF was 1.1% (95% CI: 0.9%–1.2%), and postoperatively, 67.4% (95% CI: 66.4%–68.2%) of patients could discontinue proton pump inhibitor-like drugs, and the treatment outcome was observed to be satisfactory in over 80% of the patients. Subgroup analyses of the various procedures showed that all 3 types improved several objective or subjective patient indicators. Conclusions: Based on the current meta-analysis, we conclude that rGERD can be safely and effectively treated with ECSF as an endoscopic procedure.

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“… 16 RF was also proved to be effective in relieving reflux esophagitis symptoms and reducing GERD health-related quality of life score, acid exposure time, and DeMeester score in Chinese patients with GERD. 17 One of what are common between these 2 endoscopic procedures is that both leave no artificial devices or prostheses in situ. Arts et al 18 demonstrated that the RF procedure was associated with decrease of the EGJ compliance, which further indicates that the therapeutic mechanism between ARMS and RF is partly similar.…”

Section: Discussionmentioning

confidence: 99%

“…The patient satisfaction rate after RF (62.50%) is slightly lower than that in previous study conducted in Chinese population, which showed rate of 92.60% and 96.30% at 6 months and 12 months after RF. 17 The reason may be that patients included in our study were all PPI-refractory GERD patients.…”

Section: Discussionmentioning

confidence: 99%

Randomized Controlled Trial of Anti-reflux Mucosectomy Versus Radiofrequency Energy Delivery for Proton Pump Inhibitor-refractory Gastroesophageal Reflux Disease

Wang

Lin

et al. 2023

J Neurogastroenterol Motil

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Background/Aims The efficacy and safety of anti-reflux mucosectomy (ARMS) or radiofrequency energy delivery in the treatment of gastroesophageal reflux disease (GERD) have been reported, but the difference between the 2 remains unclear. Methods This was a single center, randomized, comparative clinical study. Patients with symptoms of heartburn and/or regurgitation despite proton pump inhibitor treatment were randomly assigned to either ARMS group (n = 20) or radiofrequency group (n = 20). Primary outcome was the standardized GERD questionnaire (GERDQ) at 2 years after the procedures. Secondary outcomes were the proportions of patients with complete proton pump inhibitor (PPI) cessation and patients satisfied with the treatment. Results A total of 18 patients randomized to ARMS and 16 to radiofrequency were analyzed in this study. The operation success rate of the 2 groups was 100%. In both ARMS and radiofrequency groups, GERDQ scores at 2 years after the procedures were significantly lower than that before operation ( P = 0.044 and P = 0.046). At 2 years postoperatively, the scores of GERDQ did not differ between the 2 groups ( P = 0.755). There was no significant difference in the rate of discontinuation of PPIs and patient satisfaction in the ARMS and radiofrequency groups ( P = 0.642 and P = 0.934). Conclusions The clinical efficacy of ARMS and radiofrequency for the PPI-refractory GERD is equivalent. ARMS, the efficacy of which could be maintained for at least 2 years, is promising endoscopic management for the treatment of refractory GERD.

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Radiofrequency ablation is safe and effective in the treatment of Chinese patients with gastroesophageal reflux disease: A single‐center prospective study

Cited by 6 publications

References 32 publications

Efficacy of Endoscopic Radiofrequency Ablation for Treatment of Reflux Hypersensitivity: A Study Based on Rome IV Criteria

Efficacy of Endoscopic Radiofrequency Ablation for Treatment of Reflux Hypersensitivity: A Study Based on Rome IV Criteria

Efficacy and safety of endoscopic cardia peripheral tissue scar formation (ECSF) for the treatment of refractory gastroesophageal reflux disease: A systematic review with meta-analysis

Randomized Controlled Trial of Anti-reflux Mucosectomy Versus Radiofrequency Energy Delivery for Proton Pump Inhibitor-refractory Gastroesophageal Reflux Disease

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