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Endoscopic antireflux procedures: a good wrap?

Donald E Wakelin1, Richard E Sampliner

  • 1Section of Gastroenterology, Southern Arizona VA Health Care System and University of Arizona Health Sciences Center, 3601 S. 6th Avenue, Tucson, AZ 85723, USA.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|October 20, 2005
PubMed
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Endoscopic treatments for gastroesophageal reflux disease (GERD) show less efficacy than traditional options and carry risks. More research is needed to define outcomes and ensure patient safety with these evolving therapies.

Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery

Background:

  • Gastroesophageal reflux disease (GERD) is a common global condition.
  • Treatment options historically included medication (proton pump inhibitors) or surgery (fundoplication).
  • New endoscopic antireflux therapies aim to reduce risks associated with surgery and long-term medication use.

Purpose of the Study:

  • To critically evaluate the efficacy and safety of current endoscopic antireflux therapies.
  • To review existing literature on these novel endoscopic procedures.

Main Methods:

  • A literature review of human studies was conducted using PubMed.
  • Focus on injectable LES implants, gastric plications, and radiofrequency ablation.

Main Results:

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  • Three main endoscopic techniques exist: injectable LES implants, gastric plications, and radiofrequency ablation.
  • These therapies, approved based on uncontrolled trials, show lower efficacy compared to medical and surgical treatments.
  • A rare but significant risk of serious complications, including death, is associated with these procedures.

Conclusions:

  • Endoscopic antireflux therapies are still evolving.
  • Further randomized, sham/placebo-controlled trials are necessary to establish definitive outcomes.
  • These procedures should be used cautiously, with thorough patient discussion of risks and benefits.