Endoscopic cardial constriction with band ligation in the treatment of refractory gastroesophageal reflux disease: a preliminary feasibility study

Surg Endosc. 2021 Jul;35(7):4035-4041. doi: 10.1007/s00464-021-08397-y. Epub 2021 Apr 21.

Abstract

Background: Gastroesophageal reflux disease (GERD) is a common digestive disease, could cause extra-esophageal symptoms. Peroral endoscopic cardial constriction with band ligation (PECC-b) is a minimally invasive method for the treatment of GERD in recent years. The goals of this study were to evaluate the clinical efficacy of PECC-b to treat gastroesophageal reflux-related symptoms.

Methods: A retrospective study of patients undergoing PECC-b between January 2017 and December 2018 at a single institution was conducted. All patients confirmed GERD by endoscopy, esophageal PH-impedance monitoring, esophageal manometry and symptom questionnaires. The outcome measures included reflux-related scores, patients' satisfaction and drug independence after 12 months following surgery.

Results: A total of 68 patients, with follow-up of 12 months post surgery, were included in the final analysis. The symptom scores were all significantly decreased as compared with preoperation (P < 0.05). The esophageal symptom scores showed a better improvement than extra-esophageal symptoms (P < 0.001). Fifty-three (77.9%) patients achieved complete drug therapy independence and 52 (76.5%) patients were completely or partially satisfied with the symptom relief following surgery.

Conclusions: The PECC-b is a safe, effective and recommended approach for the control of GERD-related symptoms. Further multicenter prospective studies are required to confirm these outcomes.

Keywords: Band ligation; Extra-esophageal symptoms; Gastroesophageal reflux disease; Peroral endoscopic cardial constriction.

Publication types

  • Multicenter Study

MeSH terms

  • Constriction
  • Endoscopy
  • Esophageal pH Monitoring
  • Feasibility Studies
  • Follow-Up Studies
  • Gastroesophageal Reflux* / surgery
  • Humans
  • Manometry
  • Retrospective Studies
  • Treatment Outcome