The role of endoscopy in the management of gastroesophageal reflux disease

Kuribayashi, Shiko; Hosaka, Hiroko; Nakamura, Fumihiko; Nakata, Katsuhiko; Sato, Keigo; Itoi, Yuki; Hashimoto, Yu; Kasuga, Kengo; Tanaka, Hirohito; Uraoka, Toshio

doi:10.1002/deo2.86

Cited by 7 publications

(5 citation statements)

References 97 publications

(187 reference statements)

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“…The American Society of Gastrointestinal Endoscopic Surgery Guidelines recommend the Stretta procedure for patients [21]. However, another study reported different results [22], and the Stretta method needs to be re-examined [23]. Higuchi et al introduced the Stretta method in Japan in 2006 and reported its results [24]; however, it is not currently covered by medical insurance in Japan.…”

Section: Various Endoscopic Treatments For Gerdmentioning

confidence: 99%

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Frontiers in Endoscopic Treatment for Gastroesophageal Reflux Disease

Ota,

Takeuchi,

Higuchi

et al. 2023

Digestion

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Background: The 3rd edition of the evidence-based clinical practice guidelines for gastroesophageal reflux disease (GERD) 2021 from the Japanese Society of Gastroenterology states that the treatment strategy for potassium-competitive acid blocker (PCAB)-refractory GERD remains unclear. Furthermore, even if GERD improves with the administration of an acid secretion inhibitor, it is feared that GERD may flare up after discontinuation of the drug, resulting in some cases in which patients are forced to take vonoprazan semipermanently (the so-called PCAB-dependent cases). From a global perspective, PCAB is not yet used in all countries and regions, and measures that can be taken now for cases in which a conventional proton pump inhibitor (PPI) is inadequately effective need to be devised. Summary: Endoscopic treatment for GERD may be effective in cases where conventional proton pump inhibitors are ineffective; however, there are insufficient long-term studies to corroborate this, and its cost effectiveness is unknown. Other treatment options for PCAB or PPI-refractory GERD include surgical procedures (Nissen and Toupet operations), which have a longer history than endoscopic treatment for GERD. However, their long-term results are not as good as those of acid secretion inhibitors, and they are not cost effective. Endoscopic treatment for GERD may fill gaps in inadequate surgical treatment. In April 2022, endoscopic anti-reflux mucosal resections (ARMS [anti-reflux mucosectomy] and ESD-G [endoscopic submucosal dissection for GERD]) were approved for reimbursement, making endoscopic treatment of GERD possible throughout Japan. Key Messages: It is important to identify the background factors in cases in which endoscopic treatments are effective.

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Section: Various Endoscopic Treatments For Gerdmentioning

confidence: 99%

“…Higuchi et al introduced the Stretta method in Japan in 2006 and reported its results [24]; however, it is not currently covered by medical insurance in Japan. Methods for injecting bulking agents have not been used recently because of safety issues [23, 25].…”

Section: Various Endoscopic Treatments For Gerdmentioning

confidence: 99%

Frontiers in Endoscopic Treatment for Gastroesophageal Reflux Disease

Ota,

Takeuchi,

Higuchi

et al. 2023

Digestion

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“…45 Other endoscopic anti-reflux therapies 1) Anti-reflux mucosectomy Anti-reflux mucosectomy (ARMS) was initially introduced by Inoue et al 56 in patients with short-segment BE with high-grade -B). 57 ARMS helps create mucosal defects in approximately 2/3 to 4/5 of the circumference on the lesser curvature of the cardiac mucosa, leading to scarring and, consequently, narrowing of the EGJ opening. ARMS-C was shown to be effective and safe for GERD treatment at 6 months; 63% of the patients discontinued PPI, while 30% of the patients reduced their PPI intake.…”

Section: Endoscopic Full-thickness Suturingmentioning

confidence: 99%

Role of endoscopy in gastroesophageal reflux disease

Simadibrata,

Lesmana,

Fass

2023

Clin Endosc

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In general, gastroesophageal reflux disease (GERD) is diagnosed clinically based on typical symptoms and/or response to proton pump inhibitor treatment. Upper gastrointestinal endoscopy is reserved for patients presenting with alarm symptoms, such as dysphagia, odynophagia, significant weight loss, gastrointestinal bleeding, or anorexia; those who meet the criteria for Barrett’s esophagus screening; those who report a lack or partial response to proton pump inhibitor treatment; and those with prior endoscopic or surgical anti-reflux interventions. Newer endoscopic techniques are primarily used to increase diagnostic yield and provide an alternative to medical or surgical treatment for GERD. The available endoscopic modalities for the diagnosis of GERD include conventional endoscopy with white-light imaging, high-resolution and high-magnification endoscopy, chromoendoscopy, image-enhanced endoscopy (narrow-band imaging, I- SCAN, flexible spectral imaging color enhancement, blue laser imaging, and linked color imaging), and confocal laser endomicroscopy. Endoscopic techniques for treating GERD include esophageal radiofrequency energy delivery/Stretta procedure, transoral incisionless fundoplication, and endoscopic full-thickness plication. Other novel techniques include anti-reflux mucosectomy, peroral endoscopic cardiac constriction, endoscopic submucosal dissection, and endoscopic band ligation. Currently, many of the new endoscopic techniques are not widely available, and their use is limited to centers of excellence.

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“…Endoscopic approaches, such as radiofrequency ablation, endoscopic fundoplication, and endoscopic mucosal resection, have been developed for GERD management. These methods, notably endoscopic full-thickness plication (EFTP), are recognized for their effectiveness in symptom reduction and safety, often presenting fewer complications compared to surgical options 14 15 . Short-term outcomes post-procedure, such as immediate symptom relief and reduced medication dependency, are generally positive 15 .…”

Section: Introductionmentioning

confidence: 99%

“…EFTP represents a significant advance in minimally invasive GERD management. The technique involves creating a functional anti-reflux valve by applying transmural sutures at the gastroesophageal junction, folding and connecting gastric fundus segments to the esophagus, ultimately enhancing the valvular mechanism and reducing gastroesophageal reflux 14 15 16 . The long-term effectiveness and safety of EFTP have been supported by several randomized controlled trials (RCTs) and prospective studies 17 18 19 20 .…”

Section: Introductionmentioning

confidence: 99%

Endoscopic full-thickness plication for the treatment of gastroesophageal reflux disease: A systematic review and meta-analysis

Niu,

Zhang,

Iyer

et al. 2023

Endosc Int Open

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Background Gastroesophageal reflux disease (GERD) is a widespread chronic gastrointestinal condition with an increasing worldwide prevalence. This research aims to perform a systematic review and meta-analysis evaluating the efficacy, safety, and long-term outcomes of endoscopic full-thickness plication (EFTP) for the treatment of GERD. Methods A comprehensive search of databases was conducted for studies published up to April 2023. We included randomized controlled trials (RCTs) and prospective observational studies that examined the use of EFTP in treating GERD among adult patients. We calculated pooled effect estimates using a random-effects model. Results EFTP significantly improved GERD-HRQL scores at 3-, 6-, and 12-months follow-up intervals. A considerable proportion of patients discontinued PPIs, with cessation rates of 59% (95% CI: 0.47-0.71), 68% (95% CI: 0.58-0.78), and 67% (95% CI: 0.46-0.89,) at 3, 6, and 12 months, respectively. At 3 and 6 months, 61% (95% CI: 0.54-0.68) and 66% (95% CI: 0.56-0.76) of patients experienced ≥50% improvement in GERD-HRQL scores. EFTP demonstrated a favorable safety profile, with a low rate of severe adverse events. We observed a 6.76% (95% CI: -14.53-1.02) reduction in the percentage of time with esophageal pH <4, a decrease in DeMeester scores, and fewer total reflux episodes. The average procedure time was 22.75 minutes (95% CI: 22.03-23.48). Subgroup analyses suggest both the GERDx system and the NDO Plicator are effective and safe in treating GERD. Conclusion The findings of our study reveal that EFTP is a safe and effective treatment for GERD patients who have not responded adequately to conventional therapies. Given its minimally invasive nature, effectiveness, and limited adverse effects, EFTP emerges as a compelling alternative to conventional surgical procedures.

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The role of endoscopy in the management of gastroesophageal reflux disease

Cited by 7 publications

References 97 publications

Frontiers in Endoscopic Treatment for Gastroesophageal Reflux Disease

Frontiers in Endoscopic Treatment for Gastroesophageal Reflux Disease

Role of endoscopy in gastroesophageal reflux disease

Endoscopic full-thickness plication for the treatment of gastroesophageal reflux disease: A systematic review and meta-analysis

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