ANTIREFLUX MUCOSECTOMY. PRELIMINARY RESULTS OF A PROSPECTIVE STUDY

Aims:

Gastroesophageal reflux disease (GERD) is very prevalent and has a significant impact on quality of life. Proton pump inhibitors (PPIs) are the mainstay of treatment, but up to 30% of patients do not respond. Several endoscopic treatment systems have been developed, with disparate results. Anti-reflux mucosectomy (ARMS) is based on the resection of the gastric mucosa distal to the cardia, which, after healing, results in a retraction that remodels the cardial valve, and rectifies the angle of Hiss.

The main objective of the study is to evaluate the efficacy of ARMS by pH-metry and specific quality of life questionnaires.

Methods:

All patients submitted to ARMS, with dependent on conventional treatment who did not present a hiatus hernia, have been included consecutively and prospectively.

Results:

Since April 2018, the technique has been performed in 7 patients, average age of 41 years, a baseline deMeester score of 37.1 (mean), and a GERD questionnaire score of 19 points (mean). The average time of completion was 45 minutes, with slight bleeding occurring in three of them. The average stay was 1.5 days, without complications. The control gastroscopy at month showed the formation of a fully competent neovalve in all patients, except one. There was improvement in the GERD questionnaire, with an average decrease of 16 points and the 4 patients evaluated in the third month after technique had managed to suspend the PPIs. Of the 4 pH-metries performed on that date, 2 of them showed a normal deMeester score. The third patient remained unchanged, in which a fully competent neovalve was not achieved, despite which he presented a significant decrease in the GERD score and suspended the PPIs.

Conclusions:

The preliminary results of this study indicate that the ARMS manages to reshape the cardial valve and achieve effective control of GERD, with an excellent safety profile.