AccScience Publishing / JCTR / Volume 8 / Issue 2 / DOI: 10.18053/jctres.08.202202.004
ORIGINAL ARTICLE

Endoscopic tightening of the cardia mucosa in gastroesophageal reflux disease: A case series of 120 patients up to 1-year follow-up

Zhenhua Li1† Yongliang Li1† Yue Wu2† Mingyan Li1 Zhaobin Yan1 Shanwen Nie1 Zhitao Liang1 Bo Li1 Peiwen Zhu1 Peilin Cui2 Qinsheng Zhang1*
Show Less
1 Department of Hepatobiliary and Spleen and Gastroenterology, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou, China
2 International Medical Services, Beijing Tiantan Hospital of Capital Medical University, Beijing, China
Submitted: 24 November 2021 | Revised: 3 January 2022 | Accepted: 8 January 2022 | Published: 1 March 2022
© 2022 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
Abstract

Background and Aim: A technique of endoscopic tightening of the cardia mucosa for the treatment of gastroesophageal reflux disease (GERD) was developed and its clinical efficacy was observed.
Methods: 120 patients with GERD who underwent endoscopic tightening surgery from December 2017 to December 2019 were included in this study. GERD-Q score and constitution type of patients were evaluated preoperatively and at 1 month, 3 months, 6 months, and 1 year after surgery. In addition, effectiveness and side effects of the procedure were graded based on gastroesophageal flap valve (GEFV) function.
Results: GERD-Q score of 1 month, 3 months, 6 months, and 1 year after surgery were significantly decreased (P<0.01) compared with preoperative score. There were no significant differences between GERD-Q score of 1 month, 3 months, 6 months, and 1 year after surgery. The surgery proves to be effective in all GEFV grades, especially in Hill-III. 
Conclusion: Endoscopic tightening is an effective method for the treatment of patients with GERD, especially of Hill-III patients. Attention should be paid to cardia width, ligation ring depth, and ring number during operation.
Relevance for Patients: ETCM is a safe endoscopic procedure with minimal trauma, which has been proved effective for patients who are diagnosed with GERD. 

Keywords
endoscopic tightening of the cardia mucosa
gastroesophageal reflux disease
gastroesophageal flap valve
health management
Conflict of interest
The authors declare that there is no conflict of interest.
References

[1] Xu H. Clinical Observation of Xinkai Kujiang Method Treating Gastroesophageal Reflux Disease (Cold and Heat Mixed Type). Harbin: Heilongjiang University of Chinese Medicine; 2017. p. 1-59.
[2] Li S, Li W, Fan F, Liu X. Advances in Treatment of Refractory Gastroesophageal Reflux Disease. Chin J
Gastroenterol 2017;22:439-42.
[3] Katz PO, Gerson LB, Vela MF. Guidelines for the Diagnosis and Management of Gastroesophageal Reflux Disease. Am J Gastroenterol 2013;108:308-28.
[4] Chinese Medical Association Gastroenterology Branch. The Consensus Opinion of Chinese Gastroesophageal Reflux Disease in 2014. Chin J Gastroenterol 2015;20:155-67.
[5] Shang H, Jiao L, Song W, Wang J. Diagnosis of NonErosive Gastroesophageal Reflux Disease by I-Scan
Staining. J Clin Mil Med 2017;45:968-70.
[6] Chen J, Zhang C, Guo B, Guo Z, Li L, Jiang J, et al. Effect of Different Gastric Emptying Function on Esophageal Motility and Reflux in Patients with Gastroesophageal Reflux Disease. Chin J Med 2017;52:23-8.
[7] Wang X, Nian Y, Gu Q, Cheng Y, Jing F. Characteristics of Nocturnal Gastroesophageal Reflux and its Influencing Factors in Patients with Gerd. Chin J Gastroenterol 2017;22:610-5.
[8] Hu Z, Wang Z, Ji T, Wu J. Laparoscopic Fundoplication Plus Balloon Dilation for Esophageal Peptic Stricture
Caused by Gastroesophageal Reflux in Children. Clin Misdiagn Misther 2015;13:74-6.
[9] Trad KS, Barnes WE, Simoni G, Shughoury AB, Mavrelis PG, Raza M, Heise JA, et al. Transoral Incisionless
Fundoplication Effective in Eliminating Gerd Symptoms in Partial Responders to Proton Pump Inhibitor Therapy
at 6 Months: The Tempo Randomized Clinical Trial. Surg Innov 2014;22:26-40.
[10] Gyawali CP, Fass R. Management of Gastroesophageal Reflux Disease. Gastroenterology 2018;154:302-18.
[11] Patti MG. An Evidence-Based Approach to the Treatment of Gastroesophageal Reflux Disease. JAMA Surg
2016;151:73-8.
[12] Coronel MA, Bernardo WM, Moura DT, Moura ET, Ribeiro IB, Moura EG. The Efficacy of the Different
Endoscopic Treatments Versus Sham, Pharmacologic or Surgical Methods for Chronic Gastroesophageal Reflux
Disease: A Systematic Review and Meta-Analysis. Arq Gastroenterol 2018;55:296-305.
[13] Chinese Society of Gastroenterology. 2014 Chinese Expert Consensus on Gastroesophageal Reflux Disease. Chin J Dig 2014;34:649-61.
[14] Li H, Abulaiti A, Zhang C, Kelimu A. Progress in Diagnosis and Treatment of Gastroesophageal Reflux Disease. Chin J Gastroesophageal Reflux Dis 2015;2:175-7.
[15] Hill LD, Kozarek RA, Kraemer SJ, Aye RW, Mercer CD, Low DE, et al. The Gastroesophageal Flap Valve: In
Vitro and In Vivo Observations. Gastrointest Endosc 1996;44:541-7.
[16] Zachariah RA, Goo T, Lee RH. Mechanism and Pathophysiology of Gastroesophageal Reflux Disease. Gastrointest Endosc Clin N Am 2020;30:209-26.

Share
Back to top
Journal of Clinical and Translational Research, Electronic ISSN: 2424-810X Print ISSN: 2382-6533, Published by AccScience Publishing