Anti-reflux mucosectomy effective for GERD in long term

For patients with gastroesophageal reflux disease (GERD), anti-reflux mucosectomy (ARMS) shows long-term efficacy and is also effective for patients with reflux hypersensitivity, according to a study published online June 18 in Digestive Endoscopy.

Kazuya Sumi, M.D., from Showa University Koto-Toyosu Hospital in Tokyo, and colleagues conducted a single-center, single-arm prospective study of 88 patients with proton pump inhibitor (PPI)-refractory GERD who underwent ARMS from June 2012 to June 2017; 60 patients were followed for more than five years or received additional treatment. The rates of long-term effectiveness and PPI discontinuation were examined as the primary outcomes.

The researchers found that ARMS yielded a long-term effect in 68.3 percent of patients, and 42 percent could discontinue PPIs. Significant differences were seen in age, intensity of preoperative symptoms, and acid-related indicators. ARMS provided long-term effectiveness in 81 percent of the 27 patients with reflux hypersensitivity. Those with short- and long-term efficacy had no significant difference in subjective symptom assessment. In 23 percent of patients, additional treatment was administered, scheduled at the one- to two-year follow-up.

"ARMS is a simple endoscopic procedure that could reduce treatment costs (i.e., by weaning from PPIs) and avoid to use foreign objects," the authors write. "In addition, ARMS has the potential to bridge the gap between medical and surgical treatment, and to be effective in the long term for patients with pure GERD and reflux hypersensitivity."

One author disclosed ties to the pharmaceutical and medical device industries.

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