Outcomes of Endoscopic Antireflux Mucosectomy for the Treatment of Gastroesophageal Reflux Disease: Systematic Review and Meta-analysis.

Autor:	Galvarini M; Department of Surgery, Sanatorio Argentino of San Juan, San Juan., Angeramo CA; Department of Surgery, Hospital Alemán of Buenos Aires., Kerman J; Department of Surgery, Sanatorio Argentino of San Juan, San Juan., Balmaceda R; Department of Surgery, Sanatorio Argentino of San Juan, San Juan., Debes I; Department of Gastroenterology, Hospital Universitario Austral, Buenos Aires, Argentina., Herbella FAM; Department of Surgery, Escola Paulista de Medicina, Federal University of Sao Paulo, Sao Paulo, Brazil., Schlottmann F; Department of Surgery, Hospital Alemán of Buenos Aires.; Department of Surgery, University of Illinois at Chicago, Chicago, IL.
Jazyk:	angličtina
Zdroj:	Journal of clinical gastroenterology [J Clin Gastroenterol] 2024 Oct 01; Vol. 58 (9), pp. 851-856. Date of Electronic Publication: 2024 Oct 01.
DOI:	10.1097/MCG.0000000000002061
Abstrakt:	Objective: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders in western countries. Endoscopic procedures have recently emerged as an alternative therapy to surgery for patients with GERD. The aim of this study was to determine outcomes after endoscopic antireflux mucosectomy (ARMS). Methods: A systematic review and meta-analysis were performed to analyze outcomes after ARMS. The main outcomes included patients' satisfaction, GERD health-related quality of life, use of proton pump inhibitors, and DeMeester score. The secondary endpoint was postprocedural adverse events. A meta-analysis of proportions was used to assess the effect of each approach on different outcomes. Results: A total of 22 studies comprising 654 patients were included for analysis. The mean age of patients was 51.83 (36 to 59.39) years, and the mean body mass index was 25.06 (23.5 to 27) kg/m 2 . The weighted pooled proportion of patient satisfaction after ARMS was 65% (95% CI: 52%-76%). The pooled proportion of patients taking proton pump inhibitors decreases from 100% to 40.84% ( P < 0.001). The mean GERD health-related quality of life scores (pre 19.48 vs post 7.90, P < 0.001) and DeMeester score (pre 44.99 vs post 15.02 P = 0.005) significantly improved after ARMS. Overall morbidity rate was 27% (95% CI: 13%-47%), with a weighted pooled proportion of perforation, stricture, and bleeding of 3% (95% CI: 2%-6%), 12% (95% CI: 9%-16%), and 6% (95% CI: 2%-17%), respectively. Conclusions: Endoscopic ARMS for GERD is associated with symptomatic improvement, reduction of medical therapy, and enhanced quality of life. Refinements of the technique, however, are needed to decrease morbidity. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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