Peroral endoscopic cardial constriction in gastroesophageal reflux disease

Medicine (Baltimore). 2018 Apr;97(15):e0169. doi: 10.1097/MD.0000000000010169.

Abstract

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.

MeSH terms

  • Adult
  • China / epidemiology
  • Esophageal pH Monitoring / methods
  • Female
  • Follow-Up Studies
  • Gastroesophageal Reflux* / diagnosis
  • Gastroesophageal Reflux* / epidemiology
  • Gastroesophageal Reflux* / psychology
  • Gastroesophageal Reflux* / surgery
  • Gastroscopy* / methods
  • Gastroscopy* / statistics & numerical data
  • Humans
  • Male
  • Manometry / methods
  • Middle Aged
  • Proton Pump Inhibitors / therapeutic use
  • Quality of Life*
  • Treatment Outcome

Substances

  • Proton Pump Inhibitors