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Anti-reflux mucosectomy is an effective, safe, and well-tolerated endoscopic procedure with positive clinical outcomes for refractory GERD.
In refractory gastroesophageal reflux disease (GERD) patients, anti-reflux mucosectomy (ARMS) exhibited a high technical success rate and improved clinical response, as deciphered from a systematic review and meta-analysis published in Endoscopy International Open. Researchers aimed to assess the safety and effectiveness of ARMS for GERD management.
An extensive research of different databases was conducted to explore studies that reported results of ARMS for refractory GERD. Overall, 10 trials and 307 patients (mean age 46.9 years, 41.5% females) were included. Clinical response, technical success, and adverse events (AEs) were the outcomes evaluated. Clinical response was explained as withdrawal (full) or decrease (partial) of PPI's post-ARMS at follow-up.
Technical success rate was 97.7% while the clinical response rate was 80.1%. The pooled rate of full clinical response was 65.3% while the pooled rate of partial clinical response was 21.5 %. AE rate was 17.2%, with dysphagia/esophageal stricture being the most prevalent at 11.4%. This was followed by hemorrhage (5.0%).
The mean time for acid exposure (mean difference [MD]: 2.39), GERD Questionnaire (GERD-Q, MD: 4.85), and GERD health-related quality of life (GERD-HRQL, MD: 14.9) curtailed considerably after ARMS. On subgroup assessment, no profound differences were noted in clinical response and AEs between ARMS with banding and ARMS.
Therefore, ARMS is an effective treatment for GERD patients, with excellent clinical response rates, favorable safety profile, and is associated with significant improvement in the quality of life associated with the disease.
Endoscopy International Open
Anti-reflux mucosectomy for refractory gastroesophageal reflux disease: a systematic review and meta-analysis
Rajat Garg et al.
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