PMID- 25384555
OWN - NLM
STAT- MEDLINE
DCOM- 20150720
LR  - 20141127
IS  - 1502-7708 (Electronic)
IS  - 0036-5521 (Linking)
VI  - 49
IP  - 12
DP  - 2014 Dec
TI  - A novel endoscopic submucosal dissection technique for proton pump 
      inhibitor-refractory gastroesophageal reflux disease.
PG  - 1409-13
LID - 10.3109/00365521.2014.978815 [doi]
AB  - OBJECTIVES: Although drug treatment is the usual first-line therapy for 
      gastroesophageal reflux disease (GERD), not all patients receive satisfactory 
      relief from drug therapy, alone. We developed an endoscopic fundoplication 
      technique using endoscopic submucosal dissection (ESD); the technique is referred 
      to as ESD for GERD (ESD-G). This study investigated the safety and efficacy of 
      this novel technique in patients with drug-refractory GERD. PATIENTS AND METHODS: 
      ESD-G narrows the hiatal opening through ESD of the esophagogastric junction 
      (EGJ) mucosa. For safety reasons, the range of mucosal resection was limited to 
      half (1/2 or 1/4 +1/4) of the circumference of the EGJ lumen. ESD-G was performed 
      on 13 patients with proton pump inhibitor (PPI)-refractory GERD. GERD symptoms, 
      PPI dose, and 24-h esophageal pH monitoring results were compared before and 6 
      months after the procedure. Results. In 12 cases, symptoms significantly improved 
      after ESD-G. Five patients demonstrated improved esophagitis, three were able to 
      discontinue PPI therapy, and three were able to reduce their PPI dosage following 
      surgery. The esophageal pH <4 holding time ratio was also decreased after ESD-G. 
      Conclusions. ESD-G may be useful for PPI-refractory GERD patients.
FAU - Ota, Kazuhiro
AU  - Ota K
AD  - Second Department of Internal Medicine, Osaka Medical College , Takatsuki, Osaka 
      , Japan.
FAU - Takeuchi, Toshihisa
AU  - Takeuchi T
FAU - Harada, Satoshi
AU  - Harada S
FAU - Edogawa, Shoko
AU  - Edogawa S
FAU - Kojima, Yuichi
AU  - Kojima Y
FAU - Inoue, Takuya
AU  - Inoue T
FAU - Higuchi, Kazuhide
AU  - Higuchi K
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20141111
PL  - England
TA  - Scand J Gastroenterol
JT  - Scandinavian journal of gastroenterology
JID - 0060105
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Combined Modality Therapy
MH  - Esophageal pH Monitoring
MH  - Esophagoscopy/*methods
MH  - Esophagus/*surgery
MH  - Female
MH  - Fundoplication/*methods
MH  - Gastroesophageal Reflux/diagnosis/drug therapy/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mucous Membrane/surgery
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Treatment Outcome
OTO - NOTNLM
OT  - endoscopic submucosal dissection
OT  - gastroesophageal reflux disease
OT  - proton pump inhibitor
EDAT- 2014/11/12 06:00
MHDA- 2015/07/21 06:00
CRDT- 2014/11/12 06:00
PHST- 2014/11/12 06:00 [entrez]
PHST- 2014/11/12 06:00 [pubmed]
PHST- 2015/07/21 06:00 [medline]
AID - 10.3109/00365521.2014.978815 [doi]
PST - ppublish
SO  - Scand J Gastroenterol. 2014 Dec;49(12):1409-13. doi: 
      10.3109/00365521.2014.978815. Epub 2014 Nov 11.