Endoscopic valvuloplasty for GERD

Autor: Glen L. Lehman, John J. Nigro, Patrice Watson, Richard E. Davis, Charles J. Filipi, Tomas Martinez-Serna, Galen Perdikis, Rodney J. Mason
Rok vydání: 2000
Předmět:
Zdroj: Gastrointestinal Endoscopy. 52:663-670
ISSN: 0016-5107
Popis: Background: The transoral, endoscopic route has been suggested as a possible approach for the correction of severe gastroesophageal reflux. Such a procedure would involve no mobilization of the cardia or other structures. The optimal placement, number, and configuration of sutures remains undefined. Methods: With the use of a previously developed endoscopic sewing machine, this study was undertaken in baboons with two suture arrangements immediately below the lower esophageal sphincter. A linear arrangement (group I) and a circular arrangement (group II) were compared. During the 6 months after the procedure, the animals were evaluated using manometry, fluoroscopic barium swallow, upper gastrointestinal endoscopy, and a pressure volume test. Results: A significant increase in lower esophageal sphincter length was demonstrated only in group II (p = 0.010). A significant increase in lower esophageal sphincter pressure was demonstrated only in group I animals (p = 0.008). The abdominal length increased in group I (p = 0.004) and group II (p = 0.004). The yield pressure and yield volume did not differ significantly from those measured previously in control animals. No evidence of reflux, stricture formation, esophagitis, or other pathology was noted. Conclusions: Some manometric parameters associated with gastroesophageal reflux are altered by the endoscopic placement of sutures below the gastroesophageal junction, with no associated serious complications.
Databáze: OpenAIRE
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