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Endoscopic Reflux Treatments

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The SAGES Manual of Foregut Surgery

Abstract

The prevalence of gastroesophageal reflux disease (GERD) in Western countries ranges from 10% to 20% of the population. There is emerging data that endoscopic solutions can provide less invasive alternative therapies to treat GERD.

Several different approaches have been employed that alter the gastroesophageal junction (GEJ) to decrease reflux, namely: (i) implantation of prostheses to narrow the lumen, (ii) radiofrequency (RF) energy to induce remodeling, and (iii) sutured fundoplication. Three endoscopic devices currently have FDA approval – Stretta®, EsophyX™, and MUSE™ – and are discussed in detail in the chapter.

Endoscopic therapies for GERD continue to evolve to meet patient needs. The goal is an effective mechanical solution that can be delivered with minimal morbidity and excellent long-term durability. Currently available devices have been shown to be safe and effective in improving symptom control and quality of life and offer a well-established alternative to laparoscopic interventions.

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References

  1. Dent J, El-Serag HB, Wallander MA, Johansson S. Epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut. 2005;54:710–7.

    Article  CAS  Google Scholar 

  2. El-Serag H, Becher A, Jones R. Systematic review: persistent reflux symptoms on proton pump inhibitor therapy in primary care and community studies. Aliment Pharmacol Ther. 2010;32(6):720–37.

    Article  CAS  Google Scholar 

  3. Filipi CJ, Lehman GA, Rothstein RI, Raijman I, Stiegmann GV, Waring JP, Hunter JG, Gostout CJ, Edmundowicz SA, Dunne DP, Watson PA, Cornet DA. Transoral, flexible endoscopic suturing for treatment of GERD: a multicenter trial. Gastrointest Endosc. 2001;53(4):416–22.

    Article  CAS  Google Scholar 

  4. Triadafilopoulos G, DiBaise JK, Nostrant TT, Stollman NH. The Stretta procedure for the treatment of GERD: 6 and 12 month follow-up of the US open label trial. Gastrointest Endosc. 2002;55(2):149–56.

    Article  Google Scholar 

  5. Noar M, Squires P, Noar E, Lee M. Long-term maintenance effect of radiofrequency energy delivery for refractory GERD: a decade later. Surg Endosc. 2014;28:2323–33.

    Article  Google Scholar 

  6. Perry KA, Banerjee A, Melvin WS. Radiofrequency energy delivery to the lower esophageal sphincter reduces esophageal acid exposure and improves GERD symptoms: a systematic review and meta-analysis. Surg Laparosc Endosc Percutan Tech. 2012;22(4):283–8.

    Article  Google Scholar 

  7. Auyang ED, Carter P, Rauth T, et al. SAGES clinical spotlight review: endoluminal treatments for gastroesophageal reflux disease (GERD). Surg Endosc. 2013;27:2658–72.

    Article  Google Scholar 

  8. Lipka S, Kumar A, Richter JE. No evidence for efficacy of radiofrequency ablation for treatment of gastroesophageal reflux disease: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2015;13(6):1058–1067.e1.

    Article  Google Scholar 

  9. Cadiere GB, Rajan A, Germay O, Himpens J. Endoluminal fundoplication by a transoral device for the treatment of GERD: a feasibility study. Surg Endosc. 2008;22:333–42.

    Article  CAS  Google Scholar 

  10. Huang X, Chen S, Zhao H, Zeng X, Lian J, Tseng Y, Chen J. Efficacy of transoral incisionless fundoplication (TIF) for the treatment of GERD: a systematic review with meta-analysis. Surg Endosc. 2016;31:1032. [Epub ahead of print].

    Article  Google Scholar 

  11. Kauer WK, Roy-Shapira A, Watson D, Sonnenschein M, Sonnenschein E, Unger J, Voget M, Stein HJ. Preclinical trial of a modified gastroscope that performs a true anterior fundoplication for the endoluminal treatment of gastroesophageal reflux disease. Surg Endosc. 2009;23(12):2728–31.

    Article  Google Scholar 

  12. Kim HJ, Kwon CI, Kessler WR, Selzer DJ, McNulty G, Bapaye A, Bonavina L, Lehman GA. Long-term follow-up results of endoscopic treatment of gastroesophageal reflux disease with the MUSE™ endoscopic stapling device. Surg Endosc. 2016;30(8):3402–8.

    Article  Google Scholar 

  13. Zacherl J, Roy-Shapira A, Bonavina L, Bapaye A, Kiesslich R, Schoppmann SF, Kessler WR, Selzer DJ, Broderick RC, Lehman GA, Horgan S. Endoscopic anterior fundoplication with the Medigus Ultrasonic Surgical Endostapler (MUSE™) for gastroesophageal reflux disease: 6-month results from a multi-center prospective trial. Surg Endosc. 2015;29(1):220–9.

    Article  Google Scholar 

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Correspondence to James C. Ellsmere .

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Hawel, J.D.E., Ellsmere, J.C. (2019). Endoscopic Reflux Treatments. In: Grams, J., Perry, K., Tavakkoli, A. (eds) The SAGES Manual of Foregut Surgery . Springer, Cham. https://doi.org/10.1007/978-3-319-96122-4_15

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  • DOI: https://doi.org/10.1007/978-3-319-96122-4_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-96121-7

  • Online ISBN: 978-3-319-96122-4

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