PMID- 34790538
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20211119
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 9
IP  - 11
DP  - 2021 Nov
TI  - Antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) for 
      gastroesophageal reflux disease: a systematic review and meta-analysis.
PG  - E1740-E1751
LID - 10.1055/a-1552-3239 [doi]
AB  - Background and study aims  Antireflux mucosectomy (ARMS) and antireflux mucosal 
      ablation (ARMA) are new endoscopic procedures for patients with gastroesophageal 
      reflux disease (GERD). We conducted a meta-analysis to systematically assess the 
      feasibility, clinical success, and safety of these procedures. Patients and 
      methods  We searched Embase, PubMed, and Cochrane Central from inception to 
      October 2020. Overlapping reports, animal studies, and case reports were 
      excluded. Our primary outcomes were clinical success and adverse events (AEs). 
      Secondary outcomes included technical success, endoscopic esophagitis, 24-hour pH 
      monitoring, and proton pump inhibitor (PPI) use. A random effects model was used 
      to pool data. Results  In total, 15 nonrandomized studies (12 ARMS, n = 331; 3 
      ARMA, n = 130) were included; 10 were conducted in patients with refractory GERD. 
      The technical success rate was 100 %. The pooled short-term (first assessment 
      within the first 6 months), 1-year, and 3-year clinical success rates were 78 % 
      (95 % confidence interval [95 %CI] 70 %-85 %), 72% (95 %CI 47 %-92 %), and 73 % 
      (95 %CI 65 %-81 %), respectively. ARMS and ARMA yielded similar clinical success. 
      The proportion of patients off PPIs at 1 year was 64 % (95 %CI 52 %-75 %). There 
      were significant drops ( P  < 0.01) in validated clinical questionnaires scores, 
      presence of esophagitis, and acid exposure time. The most common AE (11 %, 95 %CI 
      8 %-15 %) was dysphagia requiring dilation (7%, 95 %CI 5 %-11 %). Four cases of 
      perforation were recorded, all in patients undergoing ARMS. Conclusions  Our 
      meta-analysis of nonrandomized studies suggests that ARMS and ARMA are safe and 
      effective for patients with GERD.
CI  - The Author(s). This is an open access article published by Thieme under the terms 
      of the Creative Commons Attribution-NonDerivative-NonCommercial License, 
      permitting copying and reproduction so long as the original work is given 
      appropriate credit. Contents may not be used for commercial purposes, or adapted, 
      remixed, transformed or built upon. 
      (https://creativecommons.org/licenses/by-nc-nd/4.0/).
FAU - Rodriguez de Santiago, Enrique
AU  - Rodriguez de Santiago E
AD  - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y 
      Cajal, Instituto Ramon y Cajal de Investigacion Sanitaria (IRYCIS), CIBEREHD, 
      Universidad de Alcala, Madrid, Spain.
FAU - Sanchez-Vegazo, Carlos Teruel
AU  - Sanchez-Vegazo CT
AD  - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y 
      Cajal, Instituto Ramon y Cajal de Investigacion Sanitaria (IRYCIS), CIBEREHD, 
      Universidad de Alcala, Madrid, Spain.
FAU - Penas, Beatriz
AU  - Penas B
AD  - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y 
      Cajal, Instituto Ramon y Cajal de Investigacion Sanitaria (IRYCIS), CIBEREHD, 
      Universidad de Alcala, Madrid, Spain.
FAU - Shimamura, Yuto
AU  - Shimamura Y
AD  - Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.
FAU - Tanabe, Mayo
AU  - Tanabe M
AD  - Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.
FAU - Alvarez-Diaz, Noelia
AU  - Alvarez-Diaz N
AD  - Medical library, Hospital Universitario Ramon y Cajal, Madrid, Spain.
FAU - Parejo, Sofia
AU  - Parejo S
AD  - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y 
      Cajal, Instituto Ramon y Cajal de Investigacion Sanitaria (IRYCIS), CIBEREHD, 
      Universidad de Alcala, Madrid, Spain.
FAU - Kazuya, Sumi
AU  - Kazuya S
AD  - Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.
FAU - Marcos-Carrasco, Natalia
AU  - Marcos-Carrasco N
AD  - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y 
      Cajal, Instituto Ramon y Cajal de Investigacion Sanitaria (IRYCIS), CIBEREHD, 
      Universidad de Alcala, Madrid, Spain.
FAU - Vazquez-Sequeiros, Enrique
AU  - Vazquez-Sequeiros E
AD  - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y 
      Cajal, Instituto Ramon y Cajal de Investigacion Sanitaria (IRYCIS), CIBEREHD, 
      Universidad de Alcala, Madrid, Spain.
FAU - Inoue, Haruhiro
AU  - Inoue H
AD  - Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.
FAU - Albillos, Agustin
AU  - Albillos A
AD  - Department of Gastroenterology and Hepatology, Hospital Universitario Ramon y 
      Cajal, Instituto Ramon y Cajal de Investigacion Sanitaria (IRYCIS), CIBEREHD, 
      Universidad de Alcala, Madrid, Spain.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20211112
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC8589565
COIS- Competing interests Dr. Inoue is an advisor for and received educational grants 
      from Olympus Medical Systems Corporation. He has also received educational grants 
      from the Takeda Pharmaceutical Company and is an advisor for the Top Corporation.
EDAT- 2021/11/19 06:00
MHDA- 2021/11/19 06:01
PMCR- 2021/11/01
CRDT- 2021/11/18 07:00
PHST- 2021/04/17 00:00 [received]
PHST- 2021/07/09 00:00 [accepted]
PHST- 2021/11/18 07:00 [entrez]
PHST- 2021/11/19 06:00 [pubmed]
PHST- 2021/11/19 06:01 [medline]
PHST- 2021/11/01 00:00 [pmc-release]
AID - 10.1055/a-1552-3239 [doi]
PST - epublish
SO  - Endosc Int Open. 2021 Nov 12;9(11):E1740-E1751. doi: 10.1055/a-1552-3239. 
      eCollection 2021 Nov.