Peroral endoscopic cardial constriction in gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is a major digestive health problem with a high and increasing incidence worldwide. Peroral endoscopic cardial constriction (PECC) was developed by our group to provide a less invasive treatment for GERD. In this preliminary follow-up study, 16 patients were enrolled and 13 patients with GERD were targeted for analysis according to the Los Angeles classification of reflux esophagitis. The GERD health-related quality of life (GERD-HRQL) scale and esophageal pH monitoring were applied to assess clinical efficiency at 3 and 6 months after PECC treatment, respectively. All GERD patients successively received PECC, and no severe treatment-related complication was reported. Before PECC treatment, the GERD-HRQL scale was 19.92 +/- 7.89. At 3 and 6 months after treatment, the GERD-HRQL scale was 4.46 +/- 4.31 and 5.69 +/- 5.07, respectively. DeMeester score was 125.50 +/- 89.64 before PECC treatment, and 16.97 +/- 12.76 and 20.32 +/- 15.22 at 3 and 6 months after PECC treatment. Furthermore, the fraction time of a pH below 4 significantly decreased at 3 and 6 months after PECC treatment. Fraction time at pH < 4 was 35.55 +/- 26.20 before PECC treatment and 7.96 +/- 13.03 and 4.72 +/- 3.78 at 3 and 6 months after PECC treatment, respectively. These results suggest that PECC treatment could significantly reduce the GERD-HRQL scale and DeMeester score (P<.01). PECC is a feasible, safe, and effective method to treatment GERD through narrowing the diameter of the cardia and preventing the reflux of stomach contents.