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Endoscopic polymer injection and endoluminal plication in treatment of gastroesophageal reflux disease: evaluation of long-term results

BACKGROUND AND STUDY AIMS:  Us of proton pump inhibitors (PPIs) has made endoscopic treatment of gastroesophageal reflux disease (GERD) more efficient, with reduction in morbidity and complications. However, some patients persist with symptoms despite medical treatment and some are not compliant wit...

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Autores principales: De Moura, Eduardo Guimarães Hourneaux, Sallum, Rubens A. A., Nasi, Ary, Coronel, Martin, De Moura, Diogo Turiani Hourneaux, De Moura, Eduardo Turiani Hourneaux, Minata, Mauricio Kazuyoshi, Cury, Marcelo, Falcão, Angela, Cecconello, Ivan, Sakai, Paulo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: © Georg Thieme Verlag KG 2018
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5943693/
https://www.ncbi.nlm.nih.gov/pubmed/29756023
http://dx.doi.org/10.1055/a-0573-1194
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author De Moura, Eduardo Guimarães Hourneaux
Sallum, Rubens A. A.
Nasi, Ary
Coronel, Martin
De Moura, Diogo Turiani Hourneaux
De Moura, Eduardo Turiani Hourneaux
Minata, Mauricio Kazuyoshi
Cury, Marcelo
Falcão, Angela
Cecconello, Ivan
Sakai, Paulo
author_facet De Moura, Eduardo Guimarães Hourneaux
Sallum, Rubens A. A.
Nasi, Ary
Coronel, Martin
De Moura, Diogo Turiani Hourneaux
De Moura, Eduardo Turiani Hourneaux
Minata, Mauricio Kazuyoshi
Cury, Marcelo
Falcão, Angela
Cecconello, Ivan
Sakai, Paulo
author_sort De Moura, Eduardo Guimarães Hourneaux
collection PubMed
description BACKGROUND AND STUDY AIMS:  Us of proton pump inhibitors (PPIs) has made endoscopic treatment of gastroesophageal reflux disease (GERD) more efficient, with reduction in morbidity and complications. However, some patients persist with symptoms despite medical treatment and some are not compliant with it or cannot afford it for financial reasons, and thus they require non-pharmacological therapeutic options such as surgical fundoplication. Surgery may be effective in the short term, but there is related morbidity and concern about its long-term efficacy. The possibility of minimally invasive endoluminal surgeries has resulted in interest in and development of newly endoscopic devices. Good short-term results with surgical fundoplication lack of studies of is with long follow-up justify our interest in this study. The aim of this study was to investigate the efficacy of endoscopic polymer injection and endoluminal full-thickness plication in the long-term control of GERD. PATIENTS AND METHODS:  Forty-seven patients with GERD who underwent an endoscopic procedure were followed up for 60 months and evaluated for total response (RT), partial response (RP) and no response (SR) to endoscopic treatment with reintroduction of PPIs. RESULTS:  Twenty-one patients received polymer injection (G0) and 26 endoluminal plication (G1). The number of patients with no response to endoscopic treatment with reintroduction of PPIs increased in time for both techniques (G0 P  = 0.006; G1 P  < 0.001). There was symptomatic improvement up to 12 months, with progressive loss of this trending up to 60 months in G0 and G1 ( P  < 0.001). Health-related quality of life score (GERD-HRQL) demonstrated TR in G0 and G1 at 1, 3, 6 and 12 months. The 60-month analysis showed an increased number of patients with SR in both groups. The quality of life assessment (SF-36) showed benefit in G0 up to 3 months. G0 showed a higher rate of complications. There were no deaths. There was healing of esophagitis at 3 months in 45 % of patients in G0 and 40 % in G1. There was no improvement in manometric or pH findings. CONCLUSION : Endoscopic therapies were ineffective in controlling GERD in the long term.
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spelling pubmed-59436932018-05-11 Endoscopic polymer injection and endoluminal plication in treatment of gastroesophageal reflux disease: evaluation of long-term results De Moura, Eduardo Guimarães Hourneaux Sallum, Rubens A. A. Nasi, Ary Coronel, Martin De Moura, Diogo Turiani Hourneaux De Moura, Eduardo Turiani Hourneaux Minata, Mauricio Kazuyoshi Cury, Marcelo Falcão, Angela Cecconello, Ivan Sakai, Paulo Endosc Int Open BACKGROUND AND STUDY AIMS:  Us of proton pump inhibitors (PPIs) has made endoscopic treatment of gastroesophageal reflux disease (GERD) more efficient, with reduction in morbidity and complications. However, some patients persist with symptoms despite medical treatment and some are not compliant with it or cannot afford it for financial reasons, and thus they require non-pharmacological therapeutic options such as surgical fundoplication. Surgery may be effective in the short term, but there is related morbidity and concern about its long-term efficacy. The possibility of minimally invasive endoluminal surgeries has resulted in interest in and development of newly endoscopic devices. Good short-term results with surgical fundoplication lack of studies of is with long follow-up justify our interest in this study. The aim of this study was to investigate the efficacy of endoscopic polymer injection and endoluminal full-thickness plication in the long-term control of GERD. PATIENTS AND METHODS:  Forty-seven patients with GERD who underwent an endoscopic procedure were followed up for 60 months and evaluated for total response (RT), partial response (RP) and no response (SR) to endoscopic treatment with reintroduction of PPIs. RESULTS:  Twenty-one patients received polymer injection (G0) and 26 endoluminal plication (G1). The number of patients with no response to endoscopic treatment with reintroduction of PPIs increased in time for both techniques (G0 P  = 0.006; G1 P  < 0.001). There was symptomatic improvement up to 12 months, with progressive loss of this trending up to 60 months in G0 and G1 ( P  < 0.001). Health-related quality of life score (GERD-HRQL) demonstrated TR in G0 and G1 at 1, 3, 6 and 12 months. The 60-month analysis showed an increased number of patients with SR in both groups. The quality of life assessment (SF-36) showed benefit in G0 up to 3 months. G0 showed a higher rate of complications. There were no deaths. There was healing of esophagitis at 3 months in 45 % of patients in G0 and 40 % in G1. There was no improvement in manometric or pH findings. CONCLUSION : Endoscopic therapies were ineffective in controlling GERD in the long term. © Georg Thieme Verlag KG 2018-05 2018-05-08 /pmc/articles/PMC5943693/ /pubmed/29756023 http://dx.doi.org/10.1055/a-0573-1194 Text en https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle De Moura, Eduardo Guimarães Hourneaux
Sallum, Rubens A. A.
Nasi, Ary
Coronel, Martin
De Moura, Diogo Turiani Hourneaux
De Moura, Eduardo Turiani Hourneaux
Minata, Mauricio Kazuyoshi
Cury, Marcelo
Falcão, Angela
Cecconello, Ivan
Sakai, Paulo
Endoscopic polymer injection and endoluminal plication in treatment of gastroesophageal reflux disease: evaluation of long-term results
title Endoscopic polymer injection and endoluminal plication in treatment of gastroesophageal reflux disease: evaluation of long-term results
title_full Endoscopic polymer injection and endoluminal plication in treatment of gastroesophageal reflux disease: evaluation of long-term results
title_fullStr Endoscopic polymer injection and endoluminal plication in treatment of gastroesophageal reflux disease: evaluation of long-term results
title_full_unstemmed Endoscopic polymer injection and endoluminal plication in treatment of gastroesophageal reflux disease: evaluation of long-term results
title_short Endoscopic polymer injection and endoluminal plication in treatment of gastroesophageal reflux disease: evaluation of long-term results
title_sort endoscopic polymer injection and endoluminal plication in treatment of gastroesophageal reflux disease: evaluation of long-term results
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5943693/
https://www.ncbi.nlm.nih.gov/pubmed/29756023
http://dx.doi.org/10.1055/a-0573-1194
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