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Published on: April 17, 2020
A long-term comparison of plication configurations for endoluminal gastroplication: circumferential versus helical
Richard E Davis1, Atif Iqbal, Janese D Gerhardt
1Department of Surgery, Creighton University School of Medicine, 601 N. 30th Street, Omaha, NE 68131, USA.
Goals:
To determine the long-term efficacy of endoluminal gastroplication (ELGP) and the most effective plication configuration.
Background:
Endoluminal gastroplication is an intriguing therapy for gastroesophageal reflux disease. We conducted a retrospective review of a prospective experience of patient cohorts comparing outcomes of the circumferential and helical plication patterns.
Study:
Twenty patients underwent ELGP, with 9 receiving the circumferential (Group 1) and 11 the helical pattern (Group 2). Manometry, endoscopy, and 24-hour pH monitoring were performed at baseline and at 6 months. Symptom scores and medication usage were assessed at baseline, 1, 3, 6, 12, and 18 months.
Results:
Both groups did not differ significantly from each other with respect to symptom improvement, medication usage, or other variables measured. At 6 months, symptom scores, histamine-2 receptor antagonist (H2RA), proton pump inhibitor usage, and hernia size decreased significantly. No other parameter showed a significant change. At the 18-month follow-up, symptom scores and H2RA usage decreased significantly.
Conclusion:
ELGP improves heartburn and regurgitation scores at 18 months. Our study suggests that there is no benefit to additional plications when using the helical pattern.
