ENDOSCOPIC THERAPY FOR GASTROESOPHAGEAL REFLUX DISEASE

DOI 105 References
  • KASUGAI Kunio
    Department of Gastroenterology, Aichi Medical University School of Medicine.
  • TOKUDOME Kentaro
    Department of Gastroenterology, Aichi Medical University School of Medicine.
  • FUNAKI Yasushi
    Department of Gastroenterology, Aichi Medical University School of Medicine.
  • YONEDA Masashi
    Department of Gastroenterology, Aichi Medical University School of Medicine.

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Other Title
  • 胃食道逆流症の内視鏡治療

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Abstract

A variety of endoscopic techniques for the treatment of gastroesophageal reflux disease (GERD) have been developed as alternatives to PPI therapy or antireflux surgery. These techniques include submucosal suture plication of gastroesophageal junction (EndoCinch, ESD) or full thickness plication of the proximal fundic folds (Plicator, EsophyX, Syntheon ARD Plicator, Hiz-Wiz, MediGus SRS), the delivery of radiofrequency energy to the gastroesophageal junction (Stretta) and inject or implant biopolymers into the lower esophageal sphincter zone (Enteryx, Gatekeeper). Each of these endoscopic techniques is designed to augment the barrier function of the gastroesophageal junction. However, the underlying mechanism of action of the various endoscopic techniques has not been completely elucidated. Most studies have the improvement of symptoms and QOL, but poor improvement of pH monitor or manometric findings. Further, these therapies have only limited follow-up information, and safety issues remain unresolved.<BR>Thus, endoscopic therapy for GERD is still evolving at this stage, and there are several newer devices under study or in development. Further studies with sham-controlled clinical trials to evaluate the subjective and objective outcome will be needed to determine the true role of endoscopic procedure for GERD.

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