Endoscopic antireflux mucosectomy improves symptoms, QOL in GERD

Patients with gastroesophageal reflux disease (GERD) who underwent endoscopic antireflux mucosectomy (ARMS) see improvements in their symptoms, a reduction of medical therapy, and a better quality of life (QOL), reports a study.

This systematic review and meta-analysis included 22 eligible studies consisting of 654 patients with GERD (mean age 51.83 years, mean BMI 25.06 kg/m²). The investigators assessed the following main outcomes: patient satisfaction, GERD health-related QOL, use of proton pump inhibitors (PPIs), and DeMeester score. They also evaluated the postprocedural adverse events.

In addition, the investigators used a meta-analysis of proportions to examine the impact of each approach on different outcomes.

Following ARMS, the weighted pooled proportion of patient satisfaction was 65 percent (95 percent confidence interval [CI], 52‒76), while that of patients taking PPIs decreased from 100 percent to 40.84 percent (p<0.001).

For GERD health-related QOL, the mean scores significantly improved from 19.48 pre-ARMS to 7.90 post-ARMS (p<0.001), while the DeMeester score improved from 44.99 before ARMS to 15.02 after ARMS (p=0.005).

The overall rate of morbidity was 27 percent (95 percent CI, 13‒47), with a weighted pooled proportion of 3 percent (95 percent CI, 2‒6) for perforation, 12 percent (95 percent CI, 9‒16) for stricture, and 6 percent (95 percent CI, 2‒17) for bleeding.

“Refinements of the technique, however, are needed to decrease morbidity,” the investigators said.