Novel Endoscopic Therapies for Gerd: A Comprehensive Systematic Review and Meta-Analysis

Kothadia, Savan; Kalligeros, Markos; Mohamed, Mouhand; Duarte-Chavez, Rodrigo; Kahaleh, Michel

doi:10.1016/j.gie.2022.04.1007

Cited by 1 publication

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“…Several studies have also conducted systematic reviews and meta-analyses of endoscopic anti-reflux therapy. [ 59 ] A study [ 60 ] performed a meta-analysis of novel endoscopic treatments (ARMA, ARMS, band ligation (banding), novel full-thickness plication, and resection and plication) and indicated that all new endoscopic therapies had a clinical success rate of 63% (95% CI: 54%–72%) and a rate of adverse events of 8% (95% CI: 3%–14%). ARAM had the highest clinical success rate of 75% (95% CI: 45%–97%).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of endoscopic cardia peripheral tissue scar formation (ECSF) for the treatment of refractory gastroesophageal reflux disease: A systematic review with meta-analysis

Shi,

ZhuoMa,

Ying

et al. 2024

Medicine

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Background: Endoscopic treatment is increasingly used for refractory gastroesophageal reflux disease (rGERD). Unlike the mechanism of conventional surgical fundoplication, gastroesophageal junction ligation, anti-reflux mucosal intervention, and radiofrequency ablation have extremely similar anti-reflux mechanisms; hence, we collectively refer to them as endoscopic cardia peripheral tissue scar formation (ECSF). We conducted a systematic review and meta-analysis to assess the safety and efficacy of ECSF in treating rGERD. Methods: We performed a comprehensive search of several databases, including PubMed, Embase, Medline, China Knowledge Network, and Wanfang, to ensure a systematic approach for data collection between January 2011 and July 2023. Forest plots were used to summarize and combine the GERD-health-related quality of life (HRQL), gastroesophageal reflux questionnaire score, and DeMeester scores, acid exposure time, lower esophageal sphincter pressure, esophagitis, proton pump inhibitors use, and patient satisfaction. Results: This study comprised 37 studies, including 1732 patients. After ECSF, significant improvement in gastroesophageal reflux disease health-related quality of life score (mean difference [MD] = 18.27 95% CI: 14.81–21.74), gastroesophageal reflux questionnaire score (MD = 4.85 95% CI: 3.96–5.75), DeMeester score (MD = 42.34, 95% CI: 31.37–53.30), acid exposure time (MD = 7.98, 95% CI: 6.03–9.92), and lower esophageal sphincter pressure was observed (MD = −5.01, 95% CI: −8.39 to 1.62). The incidence of serious adverse effects after ECSF was 1.1% (95% CI: 0.9%–1.2%), and postoperatively, 67.4% (95% CI: 66.4%–68.2%) of patients could discontinue proton pump inhibitor-like drugs, and the treatment outcome was observed to be satisfactory in over 80% of the patients. Subgroup analyses of the various procedures showed that all 3 types improved several objective or subjective patient indicators. Conclusions: Based on the current meta-analysis, we conclude that rGERD can be safely and effectively treated with ECSF as an endoscopic procedure.

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Section: Discussionmentioning

confidence: 99%