Endoscopic anti-reflux therapy for gastroesophageal reflux disease

Enrique Rodríguez de Santiago, Eduardo Albéniz, Fermin Estremera-Arevalo, Carlos Teruel Sanchez-Vegazo, Vicente Lorenzo-Zúñiga, Enrique Rodríguez de Santiago, Eduardo Albéniz, Fermin Estremera-Arevalo, Carlos Teruel Sanchez-Vegazo, Vicente Lorenzo-Zúñiga

Abstract

Gastroesophageal reflux disease has an increasing incidence and prevalence worldwide. A significant proportion of patients have a suboptimal response to proton pump inhibitors or are unwilling to take lifelong medication due to concerns about long-term adverse effects. Endoscopic anti-reflux therapies offer a minimally invasive option for patients unwilling to undergo surgical treatment or take lifelong medication. The best candidates are those with a good response to proton pump inhibitors and without a significant sliding hiatal hernia. Transoral incisionless fundoplication and nonablative radiofrequency are the techniques with the largest body of evidence and that have been tested in several randomized clinical trials. Band-assisted ligation techniques, anti-reflux mucosectomy, anti-reflux mucosal ablation, and new plication devices have yielded promising results in recent noncontrolled studies. Nonetheless, the role of endoscopic procedures remains controversial due to limited long-term and comparative data, and no consensus exists in current clinical guidelines. This review provides an updated summary focused on the patient selection, technical details, clinical success, and safety of current and future endoscopic anti-reflux techniques.

Keywords: Anti-reflux mucosal ablation; Anti-reflux mucosectomy; Gastroesophageal reflux; Stretta; Transoral incisionless fundoplication; Treatment.

Conflict of interest statement

Conflict-of-interest statement: The authors declare no conflicts of interest for this article.

©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.

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Source: PubMed

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