Japan Digestive Disease Week 2025
International Session (Workshop)1 (JGES, JSGE, JSGCS)
October 30, 15:00–17:00, Room 9 (Portopia Hotel Main Building Kairaku 3)
IS-W1-4_E
Efficacy of Antireflux Mucoplasty with Valve and Feasibility of Its Modified Approach
- 1
- Department of Gastroenterology, Shinshu University School of Medicine
Background:
Antireflux mucoplasty (ARM-P) and antireflux mucoplasty with valve (ARM-PV) are promising endoscopic treatments for proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD). However, in ARM-PV, flap fixation with clips may lead to clip embedment, complicating subsequent procedures. To address this issue, we developed a modified ARM-PV technique that omits clip fixation of the mucosal flap. Here, we report clinical outcomes of ARM-P/PV, including this modified approach.
Methods:
This was a retrospective single-center study including patients with PPI-refractory GERD who underwent ARM-P/PV. We evaluated technical success, changes in PPI usage, and improvements in GERD-related symptoms assessed by the GERD-Health Related Quality of Life Questionnaire (GERD-HRQL) and the Frequency Scale for the Symptoms of GERD (FSSG).
Results:
A total of 9 patients were included (ARM-P: 3; ARM-PV: 6, of which 5 underwent the modified approach). The median age was 59 years. Technical success was 100%. PPI use decreased: 44% discontinued PPI, and 11% reduced the dose by half. Median GERD-HRQL and FSSG scores improved from 23 to 5 (P=0.02) and 30 to 14 (P=0.01), respectively. No bleeding, perforation, or stricture was observed. In the five patients undergoing modified ARM-PV, comparable symptom improvement was observed: GERD-HRQL improved from 28 to 7, and FSSG from 27 to 16.
Conclusions:
ARM-P/PV were effective in improving GERD symptoms. Additionally, the modified ARM-PV approach appeared to be a feasible alternative.
Antireflux mucoplasty (ARM-P) and antireflux mucoplasty with valve (ARM-PV) are promising endoscopic treatments for proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD). However, in ARM-PV, flap fixation with clips may lead to clip embedment, complicating subsequent procedures. To address this issue, we developed a modified ARM-PV technique that omits clip fixation of the mucosal flap. Here, we report clinical outcomes of ARM-P/PV, including this modified approach.
Methods:
This was a retrospective single-center study including patients with PPI-refractory GERD who underwent ARM-P/PV. We evaluated technical success, changes in PPI usage, and improvements in GERD-related symptoms assessed by the GERD-Health Related Quality of Life Questionnaire (GERD-HRQL) and the Frequency Scale for the Symptoms of GERD (FSSG).
Results:
A total of 9 patients were included (ARM-P: 3; ARM-PV: 6, of which 5 underwent the modified approach). The median age was 59 years. Technical success was 100%. PPI use decreased: 44% discontinued PPI, and 11% reduced the dose by half. Median GERD-HRQL and FSSG scores improved from 23 to 5 (P=0.02) and 30 to 14 (P=0.01), respectively. No bleeding, perforation, or stricture was observed. In the five patients undergoing modified ARM-PV, comparable symptom improvement was observed: GERD-HRQL improved from 28 to 7, and FSSG from 27 to 16.
Conclusions:
ARM-P/PV were effective in improving GERD symptoms. Additionally, the modified ARM-PV approach appeared to be a feasible alternative.
- Index Term 1: antireflux mucoplasty with valve
- Index Term 2: gastroesophageal reflux disease