Surgical Endoscopy

, Volume 24, Issue 5, pp 1040–1048 | Cite as

Evaluating outcomes of endoscopic full-thickness plication for gastroesophageal reflux disease (GERD) with impedance monitoring

  • Daniel von Renteln
  • Arthur Schmidt
  • Bettina Riecken
  • Karel Caca
Article

Abstract

Background

Endoscopic full-thickness plication allows transmural suturing at the gastroesophageal junction to recreate the antireflux barrier. Multichannel intraluminal impedance monitoring (MII) can be used to detect nonacid or weakly acidic reflux, acidic swallows, and esophageal clearance time. This study used MII to evaluate the outcome of endoscopic full-thickness plication.

Methods

In this study, 12 subsequent patients requiring maintenance proton pump inhibitor therapy underwent endoscopic full-thickness plication for treatment of gastroesophageal reflux disease. With patients off medication, MII was performed before and 6-months after endoscopic full-thickness plication.

Results

The total median number of reflux episodes was significantly reduced from 105 to 64 (p = 0.016). The median number of acid reflux episodes decreased from 73 to 43 (p = 0.016). Nonacid reflux episodes decreased from 23 to 21 (p = 0.306). The median bolus clearance time was 12 s before treatment and 11 s at 6 months (p = 0.798). The median acid exposure time was reduced from 6.8% to 3.4% (p = 0.008), and the DeMeester scores were reduced from 19 to 12 (p = 0.008).

Conclusion

Endoscopic full-thickness plication significantly reduced total reflux episodes, acid reflux episodes, and total reflux exposure time. The DeMeester scores and total acid exposure time for the distal esophagus were significantly improved. No significant changes in nonacid reflux episodes and median bolus clearance time were encountered.

Keywords

Endoscopic full-thickness plication Gastroesophageal reflux disease GERD Multichannel intraluminal impedance monitoring Transmural suturing Plicator Endoscopic reflux therapy 

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Daniel von Renteln
    • 1
  • Arthur Schmidt
    • 1
  • Bettina Riecken
    • 1
  • Karel Caca
    • 1
  1. 1.Department of Gastroenterology, Hepatology, and OncologyKlinikum LudwigsburgLudwigsburgGermany

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