Endoscopic management of refractory gastroesophageal reflux disease

被引:22
作者
Seleem, Waseem M. [1 ]
Hanafy, Amr Shaaban [1 ]
Mohamed, Samir I. [2 ]
机构
[1] Zagazig Univ, Endoscopy Unit, Dept Internal Med, Gastroenterol & Hepatol Div, Zagazig, Egypt
[2] Zagazig Univ, Dept Gen Surg, Zagazig, Egypt
关键词
Refractory; GERD; endoscopic treatment; SPHINCTER AUGMENTATION; ACID SUPPRESSION; HEARTBURN; DIAGNOSIS; SYMPTOMS;
D O I
10.1080/00365521.2018.1445775
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objective: Despite the therapeutic and surgical interventions for the management of gastroesophageal reflux disease (GERD), yet the high cost and the post-operative complications had led to a significant socioeconomic burden. The aim was to evaluate the safety and efficacy of endoscopic band ligation (EBL) in the management of refractory GERD.Methods: A total of 150 patients with refractory GERD were assigned to an EBL group (banding was done at four quadrants just at the gastroesophageal junction (GEJ) (n=75) or to a control group (optimized dose of PPI, n=75). Follow-up for both groups by upper GI endoscopy to evaluate the site of the Z line from the incisors, the width of the GEJ and the coaptation of GEJ around the endoscope on retroflection. PH monitoring was performed every 3 months with GERD- QoL assessment monthly for 1 year.Results: In EBL group; 58 patients (77.3%) needed 1 session, 17 patients (22.7%) needed 2 sessions. 4 rubber bands were utilized in 44 patients (58.7%), 3 rubber bands in 31 patients (41.3%). Follow-up for 1 year revealed a highly significant improvement of the GERD- QoL score, the site of Z line with significant reduction of reflux episodes and symptom index when compared to the medical treatment group. In EBL group; there were no major adverse events including bleeding, post band ulcers, stenosis at one year follow up.Conclusion: The current study provides a novel endoscopic intervention to treat refractory GERD, which is safe, cost-effective, with no major adverse effects at one year follow up.
引用
收藏
页码:390 / 397
页数:8
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