The role of transoral incisionless fundoplication (TIF) in the management of gastroesophageal reflux disease (GERD) following peroral endoscopic myotomy (POEM): A pilot, prospective, patient-driven study.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-07-01 Epub Date: 2024-03-11 DOI:10.4103/sjg.sjg_22_24

Fares Ayoub, Tara Keihanian, Noor Zabad, Salmaan Jawaid, Kalpesh Patel, Mohamed O Othman

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引用次数: 0

Abstract

Background: Gastroesophageal reflux (GERD) is a concern after peroral endoscopic myotomy (POEM). Transoral incisionless fundoplication (TIF) has been recently described as a possible therapy for post-POEM GERD in case series.

Methods: We prospectively enrolled patients undergoing POEM who agreed to participate in objective post-procedure GERD evaluation. Patients with objective evidence of GERD and suitable anatomy were offered TIF vs. proton pump inhibitor (PPI) only. Patients who underwent TIF were compared to those on PPI-only therapy after follow-up.

Results: Of 21 enrolled POEM patients with objective testing, GERD was found in 11 (52%). Of those eligible for TIF, 4 (40%) opted to pursue TIF and were compared to those on PPI-only therapy ( n = 6). Three months post-TIF, 75% of patients had discontinued or significantly decreased PPI. There were no adverse events. GERD health-related quality of life scores were low and comparable between TIF (3.75 ± 6.2) and those who remained on PPI-only therapy (4.1 ± 5).

Conclusion: In this pilot, patient-driven prospective study, 75% of patients with post-POEM GERD undergoing TIF had stopped or significantly reduced PPI use. Post-POEM TIF is safe and effective and may be a viable alternative to PPI for POEM-related GERD; however, future studies should include a control arm and post-intervention pH monitoring.

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经口无切口胃底折叠术（TIF）在口腔内窥镜肌切开术（POEM）后胃食管反流病（GERD）治疗中的作用：一项由患者主导的前瞻性试点研究。

背景：胃食管反流（GERD）是口周内窥镜肌切开术（POEM）后的一个令人担忧的问题。最近，经口无切口胃底折叠术（TIF）被描述为治疗 POEM 术后胃食管反流病的一种可能疗法：我们前瞻性地招募了同意参加术后胃食管反流客观评估的 POEM 患者。有胃食管反流病客观证据且解剖结构合适的患者接受 TIF 与仅接受质子泵抑制剂 (PPI) 治疗。对接受 TIF 治疗的患者与仅接受 PPI 治疗的患者进行随访比较：在 21 名接受客观检测的 POEM 患者中，有 11 人（52%）被发现患有胃食管反流病。在符合 TIF 条件的患者中，有 4 人（40%）选择了 TIF，并与只接受 PPI 治疗的患者（n = 6）进行了比较。TIF 术后三个月，75% 的患者停用或显著减少了 PPI。无不良事件发生。胃食管反流病健康相关生活质量评分较低，TIF（3.75±6.2）分与仍在接受单纯 PPI 治疗的患者（4.1±5）分相当：在这项以患者为主导的前瞻性试点研究中，75% 接受 TIF 治疗的 POEM 后胃食管反流病患者已停止或显著减少了 PPI 的使用。POEM后TIF安全有效，可作为PPI治疗POEM相关胃食管反流病的可行替代方案；不过，未来的研究应包括对照组和干预后pH值监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.