The status of endoscopic therapies for gastroesophageal reflux disease.
| Autor: | Kolb JM; Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Greater Los Angeles VA, Los Angeles., Chang KJ; Digestive Health Institute, University of California, Irvine, California, USA. |
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| Jazyk: | angličtina |
| Zdroj: | Current opinion in gastroenterology [Curr Opin Gastroenterol] 2023 Jul 01; Vol. 39 (4), pp. 326-332. Date of Electronic Publication: 2023 May 26. |
| DOI: | 10.1097/MOG.0000000000000944 |
| Abstrakt: | Purpose of Review: Gastroesophageal reflux disease (GERD) is exceedingly common and can significantly impact quality of life through heartburn, troublesome regurgitation, or atypical symptoms. The initial approach is conservative lifestyle changes followed by medications with escalation to antireflux surgery as needed. Endoscopic therapy may represent a bridge between pharmacotherapy and surgery and represents an appropriate option for select individuals. Recent Findings: Appropriate patient selection for endoscopic antireflux therapies is critical to the success of the intervention. Candidates for endoscopic treatment with trans-oral incisionless fundoplication (TIF) include those with a small (<2 cm) or no hiatal hernia and a Hill valve grade 1 or 2. Transoral incisionless fundoplication with concomitant hiatal hernia repair (cTIF) is a safe and effective option that addresses both the crural diaphragm and gastroesophageal flap valve (GEFV). Summary: Endoscopic interventions for GERD continue to evolve and are not all created equal. Given our current understanding of the mechanisms of GERD, the TIF procedure stands out in its ability to re-create the optimal GEFV. In those patients with altered anatomy, endoscopic approaches may offer at least partial benefit. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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