Antireflux Endoluminal Therapies: Past and Present
The basic principle of antireflux procedures employing endoscopic intervention aims to create a mechanical barrier to prevent primary pathophysiology in gastroesophageal reflux disease (GERD). We review, highlight, and discuss the past and present status of endoluminal therapy. Currently, there are...
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2013-01-01
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Online Access: | http://dx.doi.org/10.1155/2013/481417 |
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doaj-20dc7996a74249f9802cb919026b67932020-11-24T21:54:04ZengHindawi LimitedGastroenterology Research and Practice1687-61211687-630X2013-01-01201310.1155/2013/481417481417Antireflux Endoluminal Therapies: Past and PresentKuo Chao Yew0Seng-Kee Chuah1Department of Gastroenterology and Hepatology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, 308433, SingaporeDivision of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung 833, TaiwanThe basic principle of antireflux procedures employing endoscopic intervention aims to create a mechanical barrier to prevent primary pathophysiology in gastroesophageal reflux disease (GERD). We review, highlight, and discuss the past and present status of endoluminal therapy. Currently, there are 3 commonly employed anti-reflux endoluminal procedures: fundoplication or suturing techniques (EndoCinch, NDO, and EsophyX), intramural injection or implant techniques (enhancing lower esophageal sphincter (LES) volume and/or strengthening compliance of the LES-Enteryx and Gatekeeper), and radiofrequency ablation of LES and cardia. EndoCinch plication requires further study and modification of technique before it can be recommended because of durability issues. Esophynx, the transoral incisionless fundoplication, may reduce hiatal hernias and increase LES length. Preliminary studies have shown promising reduction in symptoms and medication use but evidence concerning safety and long-term durability is still pending. The safety issue with injection technique is the main concern as evident from the incidences of implant withdrawals after reported major adverse events. Future research with cautious monitoring is required before any new implant material can be recommended for commercial application. Radiofrequency ablation therapy is regaining popularity in treating refractory symptoms despite PPI use due to improved efficacy, durability, and safety after years of refinement of protocol.http://dx.doi.org/10.1155/2013/481417 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kuo Chao Yew Seng-Kee Chuah |
spellingShingle |
Kuo Chao Yew Seng-Kee Chuah Antireflux Endoluminal Therapies: Past and Present Gastroenterology Research and Practice |
author_facet |
Kuo Chao Yew Seng-Kee Chuah |
author_sort |
Kuo Chao Yew |
title |
Antireflux Endoluminal Therapies: Past and Present |
title_short |
Antireflux Endoluminal Therapies: Past and Present |
title_full |
Antireflux Endoluminal Therapies: Past and Present |
title_fullStr |
Antireflux Endoluminal Therapies: Past and Present |
title_full_unstemmed |
Antireflux Endoluminal Therapies: Past and Present |
title_sort |
antireflux endoluminal therapies: past and present |
publisher |
Hindawi Limited |
series |
Gastroenterology Research and Practice |
issn |
1687-6121 1687-630X |
publishDate |
2013-01-01 |
description |
The basic principle of antireflux procedures employing endoscopic intervention aims to create a mechanical barrier to prevent primary pathophysiology in gastroesophageal reflux disease (GERD). We review, highlight, and discuss the past and present status of endoluminal therapy. Currently, there are 3 commonly employed anti-reflux endoluminal procedures: fundoplication or suturing techniques (EndoCinch, NDO, and EsophyX), intramural injection or implant techniques (enhancing lower esophageal sphincter (LES) volume and/or strengthening compliance of the LES-Enteryx and Gatekeeper), and radiofrequency ablation of LES and cardia. EndoCinch plication requires further study and modification of technique before it can be recommended because of durability issues. Esophynx, the transoral incisionless fundoplication, may reduce hiatal hernias and increase LES length. Preliminary studies have shown promising reduction in symptoms and medication use but evidence concerning safety and long-term durability is still pending. The safety issue with injection technique is the main concern as evident from the incidences of implant withdrawals after reported major adverse events. Future research with cautious monitoring is required before any new implant material can be recommended for commercial application. Radiofrequency ablation therapy is regaining popularity in treating refractory symptoms despite PPI use due to improved efficacy, durability, and safety after years of refinement of protocol. |
url |
http://dx.doi.org/10.1155/2013/481417 |
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