TY - JOUR
T1 - Transoral, flexible endoscopic suturing for treatment of GERD
T2 - A multicenter trial
AU - Filipi, Charles J.
AU - Lehman, Glen A.
AU - Rothstein, Richard I.
AU - Raijman, Isaac
AU - Stiegmann, Gregory V.
AU - Waring, J. Patrick
AU - Hunter, John G.
AU - Gostout, Christopher J.
AU - Edmundowicz, Steven A.
AU - Dunne, Donal P.
AU - Watson, Patrice A.
AU - Cornet, Douglas A.
PY - 2001/4
Y1 - 2001/4
N2 - A totally transoral outpatient procedure for the treatment of GERD would be appealing. A multicenter trial was initiated that included 64 patients with GERD treated with an endoscopic suturing device. Inclusion criteria were 3 or more heartburn episodes per week while not taking medication, dependency on antisecretory medicine, and documented acid reflux by pH monitoring. Exclusion criteria were dysphagia, grade 3 or 4 esophagitis, obesity, and hiatus hernia greater than 2 cm in length. Patients underwent manometry, endoscopy, 24-hour pH monitoring, and symptom severity scoring before and after the procedure. Patients were randomized to a linear or circumferential plication configuration. Adverse procedural events were recorded. Mean 6-month symptom score changes demonstrated procedural efficacy. Heartburn severity and frequency as well as regurgitation all improved (p > 0.0001 for each). Twenty-four-hour pH monitoring showed improvement in number of episodes below pH of 4 at 3 and 6 months (p < 0.0007 and 0.0002) and percentage of total time the pH was less than 4 at 6 months (p < 0.011). Plication configuration did not affect symptoms or pH monitoring results. One patient had a self-contained suture perforation that was successfully treated with antibiotics. Endoscopic gastroplasty is safe. It is associated with reduced symptoms and medication use at 6 month follow-up in patients with uncomplicated GERD.
AB - A totally transoral outpatient procedure for the treatment of GERD would be appealing. A multicenter trial was initiated that included 64 patients with GERD treated with an endoscopic suturing device. Inclusion criteria were 3 or more heartburn episodes per week while not taking medication, dependency on antisecretory medicine, and documented acid reflux by pH monitoring. Exclusion criteria were dysphagia, grade 3 or 4 esophagitis, obesity, and hiatus hernia greater than 2 cm in length. Patients underwent manometry, endoscopy, 24-hour pH monitoring, and symptom severity scoring before and after the procedure. Patients were randomized to a linear or circumferential plication configuration. Adverse procedural events were recorded. Mean 6-month symptom score changes demonstrated procedural efficacy. Heartburn severity and frequency as well as regurgitation all improved (p > 0.0001 for each). Twenty-four-hour pH monitoring showed improvement in number of episodes below pH of 4 at 3 and 6 months (p < 0.0007 and 0.0002) and percentage of total time the pH was less than 4 at 6 months (p < 0.011). Plication configuration did not affect symptoms or pH monitoring results. One patient had a self-contained suture perforation that was successfully treated with antibiotics. Endoscopic gastroplasty is safe. It is associated with reduced symptoms and medication use at 6 month follow-up in patients with uncomplicated GERD.
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U2 - 10.1067/mge.2001.113502
DO - 10.1067/mge.2001.113502
M3 - Article
C2 - 11275879
AN - SCOPUS:0035315779
SN - 0016-5107
VL - 53
SP - 416
EP - 422
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 4
ER -