Clinical efficacy study of anti-reflux mucosal ablation in gastroesophageal reflux disease

doi:10.3877/cma.j.issn.2095-8765.2024.03.002

Abstract

Abstract:

Objective

Clinical studies of Anti-reflux mucosal ablation （ARMA） for gastroesophageal reflux disease （GERD） are rare. This study observed the clinical efficacy of ARMA on GERD through a retrospective study.

Methods

Retrospective analysis of the efficacy of ARMA in patients identified as GERD by 24 h dynamic esophageal pH monitoring. Efficacy was observed by 24 h dynamic esophageal pH monitoring, GERD-Q scale score and quality-of-life rating scale （SF-36） before and after 6 months. The efficacy of ARMA in different gastroesophageal reflux valve （GEFV） grades was also observed.

Results

Thirty-six patients were included in this study. Six months after ARMA, 30 patients with positive GERD-Q scores turned negative or decreased scores, with a response rate of 83.3% （30/36）. 25 patients with positive GERD-Q score were cured without taking PPI, with a cure rate of 69.4% （25/36）. In patients with grades Ⅰ-Ⅲ of GEFV, 24 h dynamic esophageal pH monitoring showed 6 months after surgery,with a statistically significant improvement in GERD-Q score and SF-36 score （P＜0.05）. At the same time,the dosage and frequency of acid reflux, heartburn, chest pain and PPI drugs were significantly improved.Meanwhile, GEFV patients with 24 h after surgery had acid mixed reflux, and their GERD-Q scores and SF-36 scores were not statistically different compared with preoperative ones （P ＞0.05）.

Conclusion

ARMA has good efficacy in GERD patients with GEFV grade Ⅰ-Ⅲ and poor efficacy in patients with GEFV gradeⅣ.

Key words: Gastroesophageal reflux disease, Anti-reflux mucosal ablation, Gastroesophageal reflux valve

Jing Zhang, Jun Bai, Yumen Chen, Peng Zhang, Fangfang Hou, Junfang Wang, Jing Sun, Shibo Zhao, Zhe Yang, Yue Zhang, Ruifang Zhang, Hongbin Zhu. Clinical efficacy study of anti-reflux mucosal ablation in gastroesophageal reflux disease[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2024, 11(03): 121-125.

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URL: https://zhwsgflbdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-8765.2024.03.002

https://zhwsgflbdzzz.cma-cmc.com.cn/EN/Y2024/V11/I03/121

Figures/Tables 4

References 11

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指标	胃食管瓣阀分级
指标	Ⅰ级（8例）	Ⅱ级（9例）	Ⅲ级（11例）	Ⅳ级（8例）
症状
胸痛	6（75.0）	7（77.8）	8（72.7）	6（75.0）
烧心	5（62.5）	6（66.7）	7（63.6）	5（62.5）
反酸	5（62.5）	6（66.7）	9（81.8）	7（87.5）
PPI服用（QD）	5（62.5）	6（66.7）	8（72.7）	7（87.5）

指标	胃食管瓣阀分级
指标	Ⅰ级（8例）	Ⅱ级（9例）	Ⅲ级（11例）	Ⅳ级（8例）
症状
胸痛	6（75.0）	7（77.8）	8（72.7）	6（75.0）
烧心	5（62.5）	6（66.7）	7（63.6）	5（62.5）
反酸	5（62.5）	6（66.7）	9（81.8）	7（87.5）
PPI服用（QD）	5（62.5）	6（66.7）	8（72.7）	7（87.5）

胃食管瓣阀分级	评分/症状/药物服用	术前	术后	P值
Ⅰ级（8例）	GERD-Q评分	9分（8～10分）	7分（6～9分）	0.02
	SF-36评分	69分（59～78分）	79分（78～86分）	0.03
	胸痛	6例（75%）	3例（37.5%）	0.04
	烧心	5例（62.5%）	2例（25%）	0.06
	反酸	5例（62.5%）	3例（37.5%）	0.06
	PPI（QD）	5例（62.5%）	2例（25%）	0.05
Ⅱ级（9例）	GERD-Q评分	10分（9～12分）	7分（6～9分）	0.02
	SF-36评分	69分（59～79）	79分（77～85分）	0.03
	胸痛	7例（77.8%）	3例（33.3%）	0.03
	烧心	6例（66.7%）	3例（33.3%）	0.04
	反酸	6例（66.7%）	2例（22.2%）	0.03
	PPI（QD）	6例（66.7%）	3例（33.3%）	0.06
Ⅲ级（11例）	GERD-Q评分	11分（8～10分）	7分（6～10分）	0.02
	SF-36评分	73分（66～82）	79分（78～86分）	0.04
	胸痛	8例（75%）	4例（36.4%）	0.06
	烧心	7例（62.5%）	3例（27.3%）	0.04
	反酸	9例（62.5%）	3例（27.3%）	0.05
	PPI（QD）	8例（72.7%）	3例（27.3%）	0.05
Ⅳ级（8例）	GERD-Q	13分（11～15分）	11分（10～14分）	0.06
	SF-36	75分（70～81分）	78分（73～84分）	0.05
	胸痛	6例（75%）	3例（37.5%）	0.04
	烧心	5例（62.5%）	2例（25%）	0.06
	反酸	7例（87.5%）	3例（37.5%）	0.06
	PPI（QD）	7例（87.5%）	4例（50%）	0.07

胃食管瓣阀分级	评分/症状/药物服用	术前	术后	P值
Ⅰ级（8例）	GERD-Q评分	9分（8～10分）	7分（6～9分）	0.02
	SF-36评分	69分（59～78分）	79分（78～86分）	0.03
	胸痛	6例（75%）	3例（37.5%）	0.04
	烧心	5例（62.5%）	2例（25%）	0.06
	反酸	5例（62.5%）	3例（37.5%）	0.06
	PPI（QD）	5例（62.5%）	2例（25%）	0.05
Ⅱ级（9例）	GERD-Q评分	10分（9～12分）	7分（6～9分）	0.02
	SF-36评分	69分（59～79）	79分（77～85分）	0.03
	胸痛	7例（77.8%）	3例（33.3%）	0.03
	烧心	6例（66.7%）	3例（33.3%）	0.04
	反酸	6例（66.7%）	2例（22.2%）	0.03
	PPI（QD）	6例（66.7%）	3例（33.3%）	0.06
Ⅲ级（11例）	GERD-Q评分	11分（8～10分）	7分（6～10分）	0.02
	SF-36评分	73分（66～82）	79分（78～86分）	0.04
	胸痛	8例（75%）	4例（36.4%）	0.06
	烧心	7例（62.5%）	3例（27.3%）	0.04
	反酸	9例（62.5%）	3例（27.3%）	0.05
	PPI（QD）	8例（72.7%）	3例（27.3%）	0.05
Ⅳ级（8例）	GERD-Q	13分（11～15分）	11分（10～14分）	0.06
	SF-36	75分（70～81分）	78分（73～84分）	0.05
	胸痛	6例（75%）	3例（37.5%）	0.04
	烧心	5例（62.5%）	2例（25%）	0.06
	反酸	7例（87.5%）	3例（37.5%）	0.06
	PPI（QD）	7例（87.5%）	4例（50%）	0.07

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