Panta Rhei — Umdenken — — Umdenken — pp 172-176 | Cite as
Neues in der endoskopischen und chirurgischen Antirefluxtherapie / New Developments in Endoscopic and Surgical Antireflux Therapie
Zusammenfassung
In Ergänzung zu den etablierten Operationsverfahren bei gastroösophagealer Refluxkrankheit wurden in den vergangenen Jahren laparoskopische, kombiniert laparo-endoskopische, endoskopisch geführte bzw. assistierte und rein endoskopische Verfahren entwickelt (Partiell resorbierbarer Antireflux-Schal, Laparo-endoskopische intralumi-nale Valvuloplastik, Endoskopische Gastroplikatio(=Endoluminal gastroplication procedure, C. R. Bard Inc.), Endoskopische submuköse Radiofrequenz-Energie-Leitung in die glatte Muskulatur des UÖS (= Stretta procedure, Curon Medical Inc.), Endoskopische Injektion eines inerten Biopolymer (Enteryx) in die Submucosa des UÖS (=Lower Esophageal Sphincter Augmentation (LESA) procedure, Enteric Medical Technologies Inc.). Zum gegenwärtigen Zeitpunkt zeigen erste positive experimentelle und klinische Ergebnisse, daß durch diese Verfahren die Refluxbarriere am gastroösophagealen Übergang verstärkt werden kann. Aussagen zu einer breiten klinischen Applikation, einem möglichen Indikationsspektrum und langfristige Angaben zur Sicherheit und Beständigkeit dieser Verfahren sind derzeit noch nicht verfügbar.
Schlüsselwörter
Laparoskopische Antireflux-Therapie Endoskopische Antireflux-Therapie Stretta Procedure LESA ProcedureSummary
In addition to well established operative procedures for the treatment of gastroesophageal reflux disease, several laparoscopic, combined laparo-endoscopic, endoscopically guided or assisted, and purely endoscopic procedures have been developed in recent years (semiabsorbable antireflux scarf, laparo-endoscopic intraluminal valvuloplastic, endoluminal gastroplication procedure (C. R. Bard Inc.), endoscopie radiofrequency delivery to the lower esophageal sphincter (= Stretta procedure, Curon Medical Inc.), endoscopic implantable biopolymer (Enteryx) (= LESA procedure, Enteric Medical Technologies Inc.). At present, initial positive experimental and clinical results demonstrate a possible reinforcement of the reflux barrier at the esophagogastric junction. Information on a broader clinical application, a possible spectrum of indications, and long-term results on the safety and endurance of these procedures are not yet available.
Keywords
Laparoscopic Antireflux Therapy Endoscopie Antireflux Therapy Stretta Procedure LESA ProcedurePreview
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Literatur
- 1.Feussner H, Bonavina L, Collard JM, Holste J, Freys SM, Horváth ÖP, Rüdiger T, Stein HJ, Fuchs KH for the European Study Group of Antireflux Surgery (2000) Experimental evaluation of the safety and biocompatibility of a new antireflux prosthesis. Dis Esoph 13:234–239.Google Scholar
- 2.DeMeester TR, Mason RJ, Filipi CJ (1998) Endoskopische intraluminale Valvuloplastik-Eine Therapie der Zukunft für die gastroösophageale Refluxkrankheit. Chirurg 69:158–162.PubMedCrossRefGoogle Scholar
- 3.Mason RJ, Filipi CJ, DeMeeser TR, Peters J (1997) A new intraluminal antigastroesophageal reflux procedure in baboons. Gastrointest Endosc 45:283.PubMedCrossRefGoogle Scholar
- 4.Kadirkamanathan SS, Evans DF, Gong F, Yazaki E, Scott M, Swain CP (1996) Antireflux operations at flexible endoscopy using endoluminal stitching techniques: an experimental study. Gastrointest Endosc 44(2): 133–143.PubMedCrossRefGoogle Scholar
- 5.Kadirkamanathan SS, Yazaki E, Evans DF, Hepworth CC, Gong F, Swain CP (1999) An ambulant porcine model of acid reflux used to evaluate endoscopic gastroplasty. Gut 44:782–788.PubMedCrossRefGoogle Scholar
- 6.Martinez-Serna T, Davis RE, Mason R, Perdikis G, Filipi DJ, Lehman G, Nigro J, Watson P (2000) Endoscopic val-vuloplasty for GERD. Gastrointest Endosc 52(5): 663–670.PubMedCrossRefGoogle Scholar
- 7.Swain P, Park PO, Kjellin T, Gong F Kadirkamanathan SS, Appleyard M (2000) Endoscopie gastroplasty for gastro-esophageal reflux disease. DDW, ASGE-Vortrag, Abstract Nr. 4470.Google Scholar
- 8.Utley DS, Kim M, Vierra MA, Triadafilopoulous G (2000) Augmentation of lower esophageal sphincter pressure and gastric yield pressure after radiofrequency energy delivery to the gastroesophageal junction: a porcine model. Gastrointest Endosc 52(1): 81–86.PubMedCrossRefGoogle Scholar
- 9.Kim MS, Dent J, Holloway RH, Utley DS (2000) Radiofrequency energy delivery to the gastric cardia inhibits triggering of transient lower esophageal sphincter relaxation in a canine model. Gastroenterology 118(4) Suppl 2:A860.CrossRefGoogle Scholar
- 10.DiBaise JK, Akromis I, Quigley EM (2000) Efficacy of radiofrequency energy delivery to the lower esophageal sphincter in the treatment of GERD. Gastrointest Endosc 51(4): 96.Google Scholar
- 11.Triadafilopoulous G, Utley DS, DiBaise J, Nostrant T, Stollman NH, Rabine J, Kim MS, Vierra MA (2000) Radio-frequency energy application to the gastroesophageal junction for the treatment of gastroesophageal reflux disease. Gastrointest Endosc 51(4): 223.Google Scholar
- 12.Mason RJ (2000) Endoscopie augmentation of the cardia with a biocompatible injectable polymer in a porcine model. SAGES Meeting, Vortrag.Google Scholar
- 13.Deviere J (2001) Endoscopie injectables as antireflux procedure. GEEMO Meeting, Vortrag.Google Scholar