Clinical research progress of peroral endoscopic non-full-thickness therapy for gastroesophageal reflux disease_West China Medical Journal

Authors：

XU Fei ¹ , XIONG Xin ¹ , JING Xiaojuan ² ,  HE Suyu ^1,3

1. First Clinical College, Zunyi Medical University, Zunyi, Guizhou 563000, P. R. China;
2. Endoscopy Center, Suining Central Hospital, Suining, Sichuan 629000, P. R. China;
3. Fourth Department of the Digestive Disease Center, Suining Central Hospital, Suining, Sichuan 629000, P. R. China;

Corresponding author：

HE Suyu, Email: hesuyu2009@163.com

Keywords：

Gastroesophageal reflux disease; Anti-reflux mucosectomy; Radiofrequency therapy; Stretta; Peroral endoscopic cardia constriction

DOI：

10.7507/1002-0179.202002325

Video：

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Gastroesophageal reflux disease (GERD) is a common, chronic disease of the digestive system. In recent years, endoluminal therapy for GERD has become a research hotspot. The reduced anti-reflux barrier function plays an important role in the occurrence of GERD. Peroral endoscopic therapy can improve the defect of anti-reflux barrier function. According to the involved layers, the endoscopic therapy can be classified as transmural which represented by transoral incisionless and transoral incisionless fundoplication, and non-transmural which represented by peroral endoscopic cardia constriction and radiofrequency ablation. This article reviews the progress of endoscopic non-full-thickness therapy for GERD in recent years, and introduces the action mechanism of peroral endoscopic therapy of GERD, the therapy of the mucosal layer and muscle layer of anti-reflux barrier, and other treatments. The purpose is to provide a reference for further exploring suitable endoscopic treatment of GERD.

Citation： XU Fei, XIONG Xin, JING Xiaojuan, HE Suyu. Clinical research progress of peroral endoscopic non-full-thickness therapy for gastroesophageal reflux disease. West China Medical Journal, 2021, 36(7): 979-985. doi: 10.7507/1002-0179.202002325 Copy

1.	Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon Consensus. Gut, 2018, 67(7): 1351-1362.
2.	Eusebi LH, Ratnakumaran R, Yuan Y, et al. Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis. Gut, 2018, 67(3): 430-440.
3.	季锋, 汪忠镐. 2013美国胃肠病学院胃食管反流病诊断和管理指南解读. 中华胃食管反流病电子杂志, 2015(2): 70-74.
4.	El-Serag H, Becher A, Jones R. Systematic review: persistent reflux symptoms on proton pump inhibitor therapy in primary care and community studies. Aliment Pharmacol Ther, 2010, 32(6): 720-737.
5.	Elias E, Targownik LE. The clinician’s guide to proton pump inhibitor related adverse events. Drugs, 2019, 79(7): 715-731.
6.	Macke L, Schulz C, Koletzko L, et al. Systematic review: the effects of proton pump inhibitors on the microbiome of the digestive tract-evidence from next-generation sequencing studies. Aliment Pharmacol Ther, 2020, 51(5): 505-526.
7.	Tack J, Pandolfino JE. Pathophysiology of gastroesophageal reflux disease. Gastroenterology, 2018, 154(2): 277-288.
8.	Palser TR, Ceney A, Navarro A, et al. Variation in laparoscopic anti-reflux surgery across England: a 5-year review. Surg Endosc, 2018, 32(7): 3208-3214.
9.	Finks JF, Wei Y, Birkmeyer JD. The rise and fall of antireflux surgery in the United States. Surg Endosc, 2006, 20(11): 1698-1701.
10.	Thor KB, Hill LD, Mercer DD, et al. Reappraisal of the flap valve mechanism in the gastroesophageal junction. A study of a new valvuloplasty procedure in cadavers. Acta Chir Scand, 1987, 153(1): 25-28.
11.	Hill LD, Kozarek RA, Kraemer SJ, et al. The gastroesophageal flap valve: in vitro and in vivo observations. Gastrointest Endosc, 1996, 44(5): 541-547.
12.	贺德志, 王小彤, 刘冰熔, 等. 抗反流黏膜切除术治疗胃食管反流病的临床疗效观察. 中华消化内镜杂志, 2019, 36(9): 682-685.
13.	贺欢, 孔文洁, 高峰. 内镜下黏膜套扎切除术对肠化生型Barrett食管的疗效. 中华胃食管反流病电子杂志, 2017, 4(4): 161-164.
14.	Satodate H, Inoue H, Yoshida T, et al. Circumferential EMR of carcinoma arising in Barrett’s esophagus: case report. Gastrointest Endosc, 2003, 58(2): 288-292.
15.	Inoue H, Ito H, Ikeda H, et al. Anti-reflux mucosectomy for gastroesophageal reflux disease in the absence of hiatus hernia: a pilot study. Ann Gastroenterol, 2014, 27(4): 346-351.
16.	Yoo IK, Ko WJ, Kim HS, et al. Anti-reflux mucosectomy using a cap-assisted endoscopic mucosal resection method for refractory gastroesophageal disease: a prospective feasibility study. Surg Endosc, 2020, 34(3): 1124-1131.
17.	Sumi K, Inoue H, Kobayashi Y, et al. Endoscopic treatment of proton pump inhibitor-refractory gastroesophageal reflux disease with anti-reflux mucosectomy: experience of 109 cases. Dig Endosc, 2021, 33(3): 347-354.
18.	Ota K, Takeuchi T, Harada S, et al. A novel endoscopic submucosal dissection technique for proton pump inhibitor-refractory gastroesophageal reflux disease. Scand J Gastroenterol, 2014, 49(12): 1409-1413.
19.	Monino L, Gonzalez JM, Vitton V, et al. Anti-reflux mucosectomy with band ligation in the treatment of refractory gastroesophageal reflux disease. Endoscopy, 2019, 51(8): E215-E216.
20.	Hedberg HM, Kuchta K, Ujiki MB. First experience with banded anti-reflux mucosectomy (ARMS) for GERD: feasibility, safety, and technique (with video). J Gastrointest Surg, 2019, 23(6): 1274-1278.
21.	令狐恩强, 王宇菲, 王潇潇. 内镜下贲门缩窄术治疗胃食管反流病的报道一例. 中华腔镜外科杂志(电子版), 2013, 6(6): 468-469.
22.	Li X, Zhang XB, Hu HQ, et al. Effect and safety of peroral endoscopic cardial constriction for gastroesophageal reflux disease. Chin Med J (Engl), 2017, 130(14): 1749-1750.
23.	胡海清, 张海静, 靳春露, 等. 经口内镜下贲门缩窄术治疗胃食管反流病的临床研究. 中华消化内镜杂志, 2019, 36(8): 563-567.
24.	李治仝, 季锋, 韩新巍, 等. 经口内镜下贲门缩窄术治疗胃食管反流病食管外症状的效果观察. 中华消化杂志, 2019, 39(6): 405-406.
25.	Liu S, Chai N, Zhai Y, et al. New treatment method for refractory gastroesophageal reflux disease (GERD): C-BLART (clip band ligation anti-reflux therapy)-a short-term study. Surg Endosc, 2020, 34(10): 4516-4524.
26.	宁雅婵, 汪忠镐, 吴继敏, 等. 胃食管反流病1014例住院患者的诊治分析. 中华普外科手术学杂志(电子版), 2010, 4(3): 264-270.
27.	Kim MS, Holloway RH, Dent J, et al. Radiofrequency energy delivery to the gastric cardia inhibits triggering of transient lower esophageal sphincter relaxation and gastroesophageal reflux in dogs. Gastrointest Endosc, 2003, 57(1): 17-22.
28.	Kalapala R, Shah H, Nabi Z, et al. Treatment of gastroesophageal reflux disease using radiofrequency ablation (Stretta procedure): an interim analysis of a randomized trial. Indian J Gastroenterol, 2017, 36(5): 337-342.
29.	Tam WC, Schoeman MN, Zhang Q, et al. Delivery of radiofrequency energy to the lower oesophageal sphincter and gastric cardia inhibits transient lower oesophageal sphincter relaxations and gastro-oesophageal reflux in patients with reflux disease. Gut, 2003, 52(4): 479-485.
30.	Fass R, Cahn F, Scotti DJ, et al. Systematic review and meta-analysis of controlled and prospective cohort efficacy studies of endoscopic radiofrequency for treatment of gastroesophageal reflux disease. Surg Endosc, 2017, 31(12): 4865-4882.
31.	He S, Xu F, Xiong X, et al. Stretta procedure versus proton pump inhibitors for the treatment of nonerosive reflux disease: a 6-month follow-up. Medicine (Baltimore), 2020, 99(3): e18610.
32.	Auyang ED, Carter P, Rauth T, et al. SAGES clinical spotlight review: endoluminal treatments for gastroesophageal reflux disease (GERD). Surg Endosc, 2013, 27(8): 2658-2672.
33.	Liu PP, Meng QQ, Lin H, et al. Radiofrequency ablation is safe and effective in the treatment of Chinese patients with gastroesophageal reflux disease: a single-center prospective study. J Dig Dis, 2019, 20(5): 229-234.
34.	Perry KA, Banerjee A, Melvin WS. Radiofrequency energy delivery to the lower esophageal sphincter reduces esophageal acid exposure and improves GERD symptoms: a systematic review and meta-analysis. Surg Laparosc Endosc Percutan Tech, 2012, 22(4): 283-288.
35.	Noar M, Squires P, Noar E, et al. Long-term maintenance effect of radiofrequency energy delivery for refractory GERD: a decade later. Surg Endosc, 2014, 28(8): 2323-2333.
36.	Dughera L, Rotondano G, De Cento M, et al. Durability of Stretta radiofrequency treatment for GERD: results of an 8-year follow-up. Gastroenterol Res Pract, 2014, 2014: 531907.
37.	Ma L, Li T, Liu G, et al. Stretta radiofrequency treatment vs Toupet fundoplication for gastroesophageal reflux disease: a comparative study. BMC Gastroenterol, 2020, 20(1): 162.
38.	Gawron AJ, Bell R, Abu Dayyeh BK, et al. Surgical and endoscopic management options for patients with GERD based on proton pump inhibitor symptom response: recommendations from an expert U. S. panel. Gastrointest Endosc, 2020, 92(1): 78-87. e2.
39.	Lo WK, Mashimo H. Critical assessment of endoscopic techniques for gastroesophageal reflux disease. J Clin Gastroenterol, 2015, 49(9): 720-724.
40.	Kamler JP, Lemperle G, Lemperle S, et al. Endoscopic lower esophageal sphincter bulking for the treatment of GERD: safety evaluation of injectable polymethylmethacrylate microspheres in miniature swine. Gastrointest Endosc, 2010, 72(2): 337-342.
41.	Ganz RA, Fallon E, Wittchow T, et al. A new injectable agent for the treatment of GERD: results of the Durasphere pilot trial. Gastrointest Endosc, 2009, 69(2): 318-323.
42.	中国医疗保健国际交流促进会胃食管反流多学科分会. 中国胃食管反流病多学科诊疗共识. 中国医学前沿杂志(电子版), 2019, 11(9): 30-56.

1. Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon Consensus. Gut, 2018, 67(7): 1351-1362.
2. Eusebi LH, Ratnakumaran R, Yuan Y, et al. Global prevalence of, and risk factors for, gastro-oesophageal reflux symptoms: a meta-analysis. Gut, 2018, 67(3): 430-440.
3. 季锋, 汪忠镐. 2013美国胃肠病学院胃食管反流病诊断和管理指南解读. 中华胃食管反流病电子杂志, 2015(2): 70-74.
4. El-Serag H, Becher A, Jones R. Systematic review: persistent reflux symptoms on proton pump inhibitor therapy in primary care and community studies. Aliment Pharmacol Ther, 2010, 32(6): 720-737.
5. Elias E, Targownik LE. The clinician’s guide to proton pump inhibitor related adverse events. Drugs, 2019, 79(7): 715-731.
6. Macke L, Schulz C, Koletzko L, et al. Systematic review: the effects of proton pump inhibitors on the microbiome of the digestive tract-evidence from next-generation sequencing studies. Aliment Pharmacol Ther, 2020, 51(5): 505-526.
7. Tack J, Pandolfino JE. Pathophysiology of gastroesophageal reflux disease. Gastroenterology, 2018, 154(2): 277-288.
8. Palser TR, Ceney A, Navarro A, et al. Variation in laparoscopic anti-reflux surgery across England: a 5-year review. Surg Endosc, 2018, 32(7): 3208-3214.
9. Finks JF, Wei Y, Birkmeyer JD. The rise and fall of antireflux surgery in the United States. Surg Endosc, 2006, 20(11): 1698-1701.
10. Thor KB, Hill LD, Mercer DD, et al. Reappraisal of the flap valve mechanism in the gastroesophageal junction. A study of a new valvuloplasty procedure in cadavers. Acta Chir Scand, 1987, 153(1): 25-28.
11. Hill LD, Kozarek RA, Kraemer SJ, et al. The gastroesophageal flap valve: in vitro and in vivo observations. Gastrointest Endosc, 1996, 44(5): 541-547.
12. 贺德志, 王小彤, 刘冰熔, 等. 抗反流黏膜切除术治疗胃食管反流病的临床疗效观察. 中华消化内镜杂志, 2019, 36(9): 682-685.
13. 贺欢, 孔文洁, 高峰. 内镜下黏膜套扎切除术对肠化生型Barrett食管的疗效. 中华胃食管反流病电子杂志, 2017, 4(4): 161-164.
14. Satodate H, Inoue H, Yoshida T, et al. Circumferential EMR of carcinoma arising in Barrett’s esophagus: case report. Gastrointest Endosc, 2003, 58(2): 288-292.
15. Inoue H, Ito H, Ikeda H, et al. Anti-reflux mucosectomy for gastroesophageal reflux disease in the absence of hiatus hernia: a pilot study. Ann Gastroenterol, 2014, 27(4): 346-351.
16. Yoo IK, Ko WJ, Kim HS, et al. Anti-reflux mucosectomy using a cap-assisted endoscopic mucosal resection method for refractory gastroesophageal disease: a prospective feasibility study. Surg Endosc, 2020, 34(3): 1124-1131.
17. Sumi K, Inoue H, Kobayashi Y, et al. Endoscopic treatment of proton pump inhibitor-refractory gastroesophageal reflux disease with anti-reflux mucosectomy: experience of 109 cases. Dig Endosc, 2021, 33(3): 347-354.
18. Ota K, Takeuchi T, Harada S, et al. A novel endoscopic submucosal dissection technique for proton pump inhibitor-refractory gastroesophageal reflux disease. Scand J Gastroenterol, 2014, 49(12): 1409-1413.
19. Monino L, Gonzalez JM, Vitton V, et al. Anti-reflux mucosectomy with band ligation in the treatment of refractory gastroesophageal reflux disease. Endoscopy, 2019, 51(8): E215-E216.
20. Hedberg HM, Kuchta K, Ujiki MB. First experience with banded anti-reflux mucosectomy (ARMS) for GERD: feasibility, safety, and technique (with video). J Gastrointest Surg, 2019, 23(6): 1274-1278.
21. 令狐恩强, 王宇菲, 王潇潇. 内镜下贲门缩窄术治疗胃食管反流病的报道一例. 中华腔镜外科杂志(电子版), 2013, 6(6): 468-469.
22. Li X, Zhang XB, Hu HQ, et al. Effect and safety of peroral endoscopic cardial constriction for gastroesophageal reflux disease. Chin Med J (Engl), 2017, 130(14): 1749-1750.
23. 胡海清, 张海静, 靳春露, 等. 经口内镜下贲门缩窄术治疗胃食管反流病的临床研究. 中华消化内镜杂志, 2019, 36(8): 563-567.
24. 李治仝, 季锋, 韩新巍, 等. 经口内镜下贲门缩窄术治疗胃食管反流病食管外症状的效果观察. 中华消化杂志, 2019, 39(6): 405-406.
25. Liu S, Chai N, Zhai Y, et al. New treatment method for refractory gastroesophageal reflux disease (GERD): C-BLART (clip band ligation anti-reflux therapy)-a short-term study. Surg Endosc, 2020, 34(10): 4516-4524.
26. 宁雅婵, 汪忠镐, 吴继敏, 等. 胃食管反流病1014例住院患者的诊治分析. 中华普外科手术学杂志(电子版), 2010, 4(3): 264-270.
27. Kim MS, Holloway RH, Dent J, et al. Radiofrequency energy delivery to the gastric cardia inhibits triggering of transient lower esophageal sphincter relaxation and gastroesophageal reflux in dogs. Gastrointest Endosc, 2003, 57(1): 17-22.
28. Kalapala R, Shah H, Nabi Z, et al. Treatment of gastroesophageal reflux disease using radiofrequency ablation (Stretta procedure): an interim analysis of a randomized trial. Indian J Gastroenterol, 2017, 36(5): 337-342.
29. Tam WC, Schoeman MN, Zhang Q, et al. Delivery of radiofrequency energy to the lower oesophageal sphincter and gastric cardia inhibits transient lower oesophageal sphincter relaxations and gastro-oesophageal reflux in patients with reflux disease. Gut, 2003, 52(4): 479-485.
30. Fass R, Cahn F, Scotti DJ, et al. Systematic review and meta-analysis of controlled and prospective cohort efficacy studies of endoscopic radiofrequency for treatment of gastroesophageal reflux disease. Surg Endosc, 2017, 31(12): 4865-4882.
31. He S, Xu F, Xiong X, et al. Stretta procedure versus proton pump inhibitors for the treatment of nonerosive reflux disease: a 6-month follow-up. Medicine (Baltimore), 2020, 99(3): e18610.
32. Auyang ED, Carter P, Rauth T, et al. SAGES clinical spotlight review: endoluminal treatments for gastroesophageal reflux disease (GERD). Surg Endosc, 2013, 27(8): 2658-2672.
33. Liu PP, Meng QQ, Lin H, et al. Radiofrequency ablation is safe and effective in the treatment of Chinese patients with gastroesophageal reflux disease: a single-center prospective study. J Dig Dis, 2019, 20(5): 229-234.
34. Perry KA, Banerjee A, Melvin WS. Radiofrequency energy delivery to the lower esophageal sphincter reduces esophageal acid exposure and improves GERD symptoms: a systematic review and meta-analysis. Surg Laparosc Endosc Percutan Tech, 2012, 22(4): 283-288.
35. Noar M, Squires P, Noar E, et al. Long-term maintenance effect of radiofrequency energy delivery for refractory GERD: a decade later. Surg Endosc, 2014, 28(8): 2323-2333.
36. Dughera L, Rotondano G, De Cento M, et al. Durability of Stretta radiofrequency treatment for GERD: results of an 8-year follow-up. Gastroenterol Res Pract, 2014, 2014: 531907.
37. Ma L, Li T, Liu G, et al. Stretta radiofrequency treatment vs Toupet fundoplication for gastroesophageal reflux disease: a comparative study. BMC Gastroenterol, 2020, 20(1): 162.
38. Gawron AJ, Bell R, Abu Dayyeh BK, et al. Surgical and endoscopic management options for patients with GERD based on proton pump inhibitor symptom response: recommendations from an expert U. S. panel. Gastrointest Endosc, 2020, 92(1): 78-87. e2.
39. Lo WK, Mashimo H. Critical assessment of endoscopic techniques for gastroesophageal reflux disease. J Clin Gastroenterol, 2015, 49(9): 720-724.
40. Kamler JP, Lemperle G, Lemperle S, et al. Endoscopic lower esophageal sphincter bulking for the treatment of GERD: safety evaluation of injectable polymethylmethacrylate microspheres in miniature swine. Gastrointest Endosc, 2010, 72(2): 337-342.
41. Ganz RA, Fallon E, Wittchow T, et al. A new injectable agent for the treatment of GERD: results of the Durasphere pilot trial. Gastrointest Endosc, 2009, 69(2): 318-323.
42. 中国医疗保健国际交流促进会胃食管反流多学科分会. 中国胃食管反流病多学科诊疗共识. 中国医学前沿杂志(电子版), 2019, 11(9): 30-56.

West China Medical Journal

Clinical research progress of peroral endoscopic non-full-thickness therapy for gastroesophageal reflux disease

Abstract Full text Figures/Tables Video References Cited by

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