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Short-term and long-term outcome of endoluminal gastroplication for the treatment of GERD: the first multicenter trial in Japan

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Abstract

Purpose

Endoluminal gastroplication (ELGP) was the first endoscopic therapy for gastroesophageal reflux disease (GERD). Data on the long-term outcomes, including the plication status and data from Asian populations, are limited. The aim of this study was to evaluate the short-term and long-term effectiveness and safety of ELGP for GERD in the Japanese population.

Methods

This was an open-label, prospective, multicenter trial of ELGP. Forty-eight patients with GERD were enrolled. The procedure involved placing circumferential plications 1–2 cm below the GE junction using the EndoCinch system. Outcome measurements were improvement of heartburn, medication use, endoscopic Los Angeles grade, durability of plications, 24-h esophageal acid exposure, esophageal manometry, and frequency of adverse events.

Results

During the 24-month follow-up, the rate of complete resolution of heartburn ranged from 54 to 66%, the rate of discontinuation or reduction of PPI/H2RA use ranged from 65 to 76%, and the rate of endoscopic classification to grade O ranged from 66 to 81%. The status with more than one plication remaining was associated with higher rates of improvement of heartburn, PPI/H2RA use, and endoscopic findings as compared with those associated with the loss of all plications. A modest decrease of the esophageal acid exposure level, but no change of the manometric parameters, was observed after ELGP. No serious adverse events were observed.

Conclusions

In this 24-month follow-up study conducted in Japanese subjects, ELGP was found to be effective in about 60% of patients with GERD, and the procedure was safe.

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Acknowledgments

The authors thank Professor Shuji Hashimoto, Department of Hygiene, School of Medicine, Fujita Health University, for his invaluable help with the statistical analysis.

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Authors and Affiliations

  1. Department of General and Gastrointestinal Surgery, School of Medicine, Fujita Health University, 3-6-10 Otobashi, Nakagawa-ku, Nagoya, Aichi, 454-8509, Japan

    Soji Ozawa

  2. Department of Surgery, Hino Municipal Hospital, Hino, Tokyo, Japan

    Koichiro Kumai

  3. 2nd Department of Internal Medicine, Osaka Medical College, Takatsuki, Osaka, Japan

    Kazuhide Higuchi

  4. Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Osaka, Japan

    Tetsuo Arakawa

  5. Division of Endoscopy, Hokkaido University Hospital, Sapporo, Hokkaido, Japan

    Mototsugu Kato

  6. Department of Gastroenterology and Hematology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan

    Masahiro Asaka

  7. Department of Surgery, School of Medicine, Kitasato University, Sagamihara, Kanagawa, Japan

    Natsuya Katada

  8. Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

    Hiroyuki Kuwano

  9. Department of Surgery, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan

    Masaki Kitajima

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  1. Soji Ozawa
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Correspondence to Soji Ozawa.

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Ozawa, S., Kumai, K., Higuchi, K. et al. Short-term and long-term outcome of endoluminal gastroplication for the treatment of GERD: the first multicenter trial in Japan. J Gastroenterol 44, 675–684 (2009). https://doi.org/10.1007/s00535-009-0064-4

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  • DOI: https://doi.org/10.1007/s00535-009-0064-4

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