Randomized Controlled Trial of Anti-reflux Mucosectomy Versus Radiofrequency Energy Delivery for Proton Pump Inhibitor-refractory Gastroesophageal Reflux Disease.

IF 3.3 3区 医学 Q2 CLINICAL NEUROLOGY
Yan Wang, Meihui Lv, Lin Lin, Liuqin Jiang
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Abstract

Background/aims: The efficacy and safety of anti-reflux mucosectomy (ARMS) or radiofrequency energy delivery in the treatment of gastroesophageal reflux disease (GERD) have been reported, but the difference between the 2 remains unclear.

Methods: This was a single center, randomized, comparative clinical study. Patients with symptoms of heartburn and/or regurgitation despite proton pump inhibitor treatment were randomly assigned to either ARMS group (n = 20) or radiofrequency group (n = 20). Primary outcome was the standardized GERD questionnaire (GERDQ) at 2 years after the procedures. Secondary outcomes were the proportions of patients with complete proton pump inhibitor (PPI) cessation and patients satisfied with the treatment.

Results: A total of 18 patients randomized to ARMS and 16 to radiofrequency were analyzed in this study. The operation success rate of the 2 groups was 100%. In both ARMS and radiofrequency groups, GERDQ scores at 2 years after the procedures were significantly lower than that before operation (P = 0.044 and P = 0.046). At 2 years postoperatively, the scores of GERDQ did not differ between the 2 groups (P = 0.755). There was no significant difference in the rate of discontinuation of PPIs and patient satisfaction in the ARMS and radiofrequency groups (P = 0.642 and P = 0.934).

Conclusions: The clinical efficacy of ARMS and radiofrequency for the PPI-refractory GERD is equivalent. ARMS, the efficacy of which could be maintained for at least 2 years, is promising endoscopic management for the treatment of refractory GERD.

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抗反流粘膜切除术与射频能量输送治疗质子泵抑制剂难治性胃食管反流病的随机对照试验
背景/目的:抗反流粘膜切除术(ARMS)或射频能量输送治疗胃食管反流病(GERD)的疗效和安全性已有报道,但两者之间的差异尚不清楚。方法:这是一项单中心、随机对照临床研究。尽管质子泵抑制剂治疗,仍有烧心和/或反流症状的患者被随机分配到ARMS组(n = 20)或射频组(n = 20)。主要结果是手术后2年的标准化GERD问卷(GERDQ)。次要结局是质子泵抑制剂(PPI)完全停用的患者比例和对治疗满意的患者比例。结果:本研究共分析了18例随机分为ARMS组,16例随机分为射频组。两组手术成功率均为100%。ARMS组和射频组术后2年GERDQ评分均显著低于术前(P = 0.044和P = 0.046)。术后2年,两组患者的GERDQ评分无显著差异(P = 0.755)。ARMS组和射频组ppi停药率和患者满意度差异无统计学意义(P = 0.642和P = 0.934)。结论:ARMS与射频治疗ppi难治性胃食管反流的临床疗效相当。ARMS的疗效至少可维持2年,是治疗难治性胃食管反流的内镜治疗方法。
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来源期刊
Journal of Neurogastroenterology and Motility
Journal of Neurogastroenterology and Motility GASTROENTEROLOGY & HEPATOLOGY-CLINICAL NEUROLOGY
CiteScore
6.30
自引率
8.80%
发文量
96
期刊介绍: Journal of Neurogastroenterology and Motility (J Neurogastroenterol Motil) is a joint official journal of the Korean Society of Neurogastroenterology and Motility, the Thai Neurogastroenterology and Motility Society, the Japanese Society of Neurogastroenterology and Motility, the Indian Motility and Functional Disease Association, the Chinese Society of Gastrointestinal Motility, the South East Asia Gastro-Neuro Motility Association, the Taiwan Neurogastroenterology and Motility Society and the Asian Neurogastroenterology and Motility Association, launched in January 2010 after the title change from the Korean Journal of Neurogastroenterology and Motility, published from 1994 to 2009.
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