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CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(02): E133-E138
DOI: 10.1055/a-1031-9436
Original article
Owner and Copyright © Georg Thieme Verlag KG 2020

Anti-reflux mucosal ablation (ARMA) as a new treatment for gastroesophageal reflux refractory to proton pump inhibitors: a pilot study[*]

Haruhiro Inoue
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Mayo Tanabe
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Enrique Rodríguez de Santiago
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
2   Department of Gastroenterology and Hepatology, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, IRYCIS, Madrid, Spain
,
Mary Raina Angeli Abad
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Yuto Shimamura
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Yusuke Fujiyoshi
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Akiko Ueno
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Kazuya Sumi
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Hideomi Tomida
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Yugo Iwaya
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Haruo Ikeda
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
,
Manabu Onimaru
1   Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

submitted 17 July 2019

accepted after revision 12 September 2019

Publication Date:
22 January 2020 (online)

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Abstract

Background The incidence of proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD) has been increasing. While surgical intervention with Laparoscopic Nissen Fundoplication remains the gold standard, less invasive anti-reflux interventions are desired. We have developed a minimally invasive anti-reflux mucosal ablation (ARMA) treatment. Herein, we report its technical details and describe its feasibility, safety, and efficacy in PPI-refractory GERD.

Methods We conducted a prospective single-center single-arm interventional trial evaluating the outcome of ARMA in 12 patients with PPI-refractory GERD. GERD-Health Related Quality of Life Questionnaire (GERD-HRQL) evaluation, Frequency Scale for the Symptoms of GERD (FSSG) assessment, and impedance-pH monitoring were performed at baseline and at 2 months post-ARMA.

Results A total of 12 patients underwent ARMA with a median follow-up duration of 9 months (range: 6 – 14 months). Median GERD-HRQL score significantly improved from 30.5 to 12 (P = 0.002); median FSSG score significantly improved from 25 to 10.5 (P = 0.002), and median DeMeester score decreased from 33.5 to 2.8 (P = 0.049) at 2 months follow-up. No immediate complications were observed.

Conclusion Our pilot study has shown that ARMA, a new endoscopic treatment for PPI-refractory GERD, is simple, safe, and improves GERD-related symptoms and objective acid reflux parameters.

* The abstract of an earlier version of this article was presented at Digestive Disease Week 2019 (May 2019; San Diego, CA, USA).


Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2020; 52(03): 239-239
DOI: 10.1055/a-1074-1647

 

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