Abstract
Abstract
Background and aims
Endoscopic anti‐reflux therapies like anti‐reflux mucosectomy (ARMS) and anti‐reflux mucosal ablation have shown efficacy for gastroesophageal reflux disease (GERD) in systematic reviews and meta‐analyses. Anti‐reflux mucoplasty (ARM‐P), a refinement of ARMS, incorporates immediate closure of the resection site to reduce complications. Recently, anti‐reflux mucosal valvuloplasty (ARMV), which employs endoscopic submucosal dissection to create a mucosal valve, was introduced but retains ARMS's limitations, requiring extensive incisions (three‐quarters to four‐fifths circumference). To address these challenges, we developed anti‐reflux mucoplasty with valve (ARM‐P/V), integrating ARMV's valvuloplasty with ARM‐P's closure technique to improve safety and reduce complications. This pilot study evaluates the safety, feasibility, and efficacy of ARM‐P/V.
Methods
This retrospective study reviewed data from patients undergoing ARM‐P/V for proton pump inhibitor (PPI)‐refractory or PPI‐dependent GERD at Showa University Koto Toyosu Hospital, Tokyo, from April to August 2024. Symptom severity and quality of life were assessed using validated questionnaires (GERD‐Health Related Quality of Life Questionnaire [GERD‐HRQL], GERD Questionnaire [GerdQ], and Frequency Scale for the Symptoms of GERD [FSSG]), comparing pre‐ and post‐treatment scores. PPI discontinuation rates were also analyzed.
Results
Eighteen patients (mean age 55.4 years) underwent ARM‐P/V. Within 3 months, 72.2% (13/18) reduced or discontinued PPI use. GERD‐HRQL scores improved from 20.3 to 10.9 (
p
= 0.004), GerdQ from 10.4 to 6.9 (
p
p
Conclusions
ARM‐P/V demonstrates safety, technical feasibility, and short‐term efficacy in GERD treatment. As a refinement of ARMV, it offers a promising alternative to current techniques.