ANTIREFLUX MUCOSECTOMY: A NEW TREATMENT FOR REFRACTORY GASTOESOPHAGEAL REFLUX DISEASE IN MONGOLIA Travel Award

Antireflux mucosectomy and antireflux mucosal ablation are new endoscopic procedures for patients with gastroesophageal reflux disease. Gastroesophageal reflux disease is common disorder with an estimated worldwide prevalence of 14.8%. GERD is the main risk factor for Barrets esophagus, can significantly affect patient quality of life and can lead to esophageal cancer. PPI are the mainstay of therapy but about 10% to 40% of patients do not achieve a satisfactory response. In Mongolia GERD is also common disorder with estimated prevalence of 28.9%. In this study 23 patients with treatment refractory GERD received ARMS and EGJ mucosa was conducted with standart techniques of ESD at least 3cm length with the length of mucosal resection at the cardia measured in retroflexion from the gastric side. The evalution of symptom improvement was measured using the GERDQ questionnaire and the flap valve grade was assessed using the Hill grade classification. In the GERDQ questionnaire mean score decreased from 11.9 to 6.6. The flap valve grade assessed during follow up endoscopic examination decreased from 3.1 to 0.8 . In this study ARMS for GERD with hiatal hernia showed excellent short term result. ARMS is a safe and effective procedure for treatment of refractory GERD with high rates of clinical response acceptable safety profile and significant improvement in GERD related quality of life.