Outcomes of endoscopic submucosal dissection for gastroesophageal reflux disease (ESD-G) for medication-refractory gastroesophageal reflux disease: 35 cases underwent ESD-G including 15 cases followed more than 5 years

• Published in: BMC gastroenterology Vol. 21; no. 1; p. 432
• Main Authors: Ota, Kazuhiro, Takeuchi, Toshihisa, Kojima, Yuichi, Sugawara, Noriaki, Nishida, Shinya, Iwatsubo, Taro, Kawaguchi, Shimpei, Harada, Satoshi, Tokioka, Satoshi, Higuchi, Kazuhide
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 18.11.2021; BioMed Central; BMC
• Subjects: Acids; Care and treatment; Disease; Dissection; Endoscopic Mucosal Resection; Endoscopic surgery; Endoscopy; ESD-G; Esophagitis; Esophagitis, Peptic - drug therapy; Esophagitis, Peptic - etiology; Esophagus; Gastrectomy; Gastric juice; Gastroenterology; Gastroesohageal reflux disease; Gastroesophageal reflux; Gastroesophageal Reflux - drug therapy; Gastroesophageal Reflux - surgery; Gastrointestinal system; Hiatal hernias; Humans; Patient outcomes; Patients; Proton pump inhibitor; Proton pump inhibitors; Proton Pump Inhibitors - therapeutic use; Secretion; Surgery; Treatment Outcome; Japan; Los Angeles California; United States > US; Gastroesohageal reflux disease; Endoscopic surgery; ESD-G; Proton pump inhibitor
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-021-02022-x

Although some kinds of endoluminal surgery for patients with proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease (GERD) have been reported, there are few reports on their long-term outcomes. In 2014, we reported the effectiveness of endoscopic surgery for PPI-refractory GERD, which we invented and named endoscopic submucosal dissection for GERD (ESD-G) in 2008. Thereafter, we accumulated more cases and monitored the patients' condition postoperatively and describe the outcomes herein. This single-center, single-arm trial was conducted at the Osaka Medical and Pharmaceutical University Hospital. We compared outcomes between before and 3-6 months after ESD-G. Additionally, we investigated the outcomes of patients 5 or more years after ESD-G. We performed 42 ESD-G procedures in 35 patients between 2008 and 2020. In seven patients, ESD-G was performed twice for various reasons. The frequency scale for the symptoms of GERD score was significantly improved 3-6 months after ESD-G (22 → 10, p < 0.0001); the Los Angeles classification for reflux esophagitis was clearly improved after ESD-G (p = 0.0423). The number of reflux episodes was not decreased by ESD-G. There was a significant difference in the potency unit of gastric acid secretion suppressants for controlling GERD-related symptoms between baseline and 3-6 months after ESD-G (p = 0.0009). In patients without a history of distal gastrectomy who underwent ESD-G, the potency unit of gastric acid secretion suppressants significantly decreased 5 or more years after ESD-G (p = 0.0121). ESD-G may be effective in patients with refractory GERD-related symptoms without a history of distal gastrectomy.