Endoluminal gasrtroplication for gastroesophageal reflux disease
- VernacularTitle:胃镜下腔内折叠术治疗胃食管反流病
- Author:
Yunsheng YANG
;
Enqiang LINGHU
;
Gang SUN
- Publication Type:Journal Article
- Keywords:
Gastroesophageal reflux disease;
Endoluminal gasrtroplication
- From:
Chinese Journal of Digestive Endoscopy
1996;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective The transoral endoluminal gasrtroplication (ELGP) is a new endoscopic therapy in gastroesophageal reflux disease (GERD) . We studied this procedure on its safety, indications, contraindications and the primary efficacy. Methods Routine endoscopic examination followed ELGP was performed in 26 patients with GERD, including 2 patients with resection of cardiac orifice. These patients suffered from 3 times or more episodes of heartburn or regurgitation per week while withdrew any medication, and the acid reflux was verified by 24-hour pH monitoring. The ELGP was performed with a linear pattern in 8 patients, circumferential in 14 cases and the combination of both patterns in 4 patients. The esophageal hiatus was 1.5 - 3. 5 cm in diameter, with average of 2. 5 cm in 26 patinets, and 20 patients were identifed to suffer from hiatus hernia. The suturing device was available of the BARD Suturing System II. Results The plicae were within 3 cm from the squamocolumnar junction or gastroesophageal stoma, sutured on the lesser curve with linear configuration in 11 patients, around the cardiac orifice with circumferential configuration in 17 cases and with the combination of both configurations in 4 patients. The distance was 1 - 3 cm between two stitchs and 1.5 - 2 cm between two folds. Thirty - two procedures were finished in 26 patiensts with a total of 60 plicae, second procedure was required in 6 patients. Each patient was sutured for 1 - 4 plicae with an average of 2. 3 plicae. The heartburn and regurgitation were improved in 76% of patients, resolved completely in 36% and remitted partly in 40%. Dyspnoea happened in one patient during operation as having suffered from cold, and the others were free of serious complications. Conclusions The symptoms of GERD can be significantly improved by ELGP which are applicable to GERD with 3 times or more episodes of heartburn or regurgitation per week,or the reflux from resection of cardiac orifice. This procedure generally is effective, convenient and safe,but it is not indicated in patients with acute cold, serious pulmonary or heart diseases.
