PMID- 35692929
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 10
IP  - 6
DP  - 2022 Jun
TI  - Anti-reflux mucosectomy for refractory gastroesophageal reflux disease: a 
      systematic review and meta-analysis.
PG  - E854-E864
LID - 10.1055/a-1802-0220 [doi]
AB  - Background and study aims  Anti-reflux mucosectomy (ARMS) is an emerging 
      endoscopic treatment for refractory gastroesophageal reflux disease (GERD). We 
      conducted a systematic review and meta-analysis to evaluate the safety and 
      efficacy ARMS in refractory GERD. Methods  A comprehensive search of multiple 
      databases (through March 2020) was performed to identify studies that reported 
      outcomes of ARMS for refractory GERD. Outcomes assessed included technical 
      success, clinical response, and adverse events (AEs). Clinical response was 
      defined as discontinuation (complete) or reduction (partial) of proton pump 
      inhibitors post-ARMS at follow up. Results  A total of 307 patients (mean age 
      46.9 [8.1] years, 41.5 % females) were included from 10 studies. The technical 
      success and clinical response rates were 97.7 % (95 % confidence interval [CI], 
      94.6-99.0) and 80.1 % (95 % CI, 61.6-91.0), respectively. The pooled rate of 
      complete and partial clinical response was 65.3 % (95 % CI, 51.4-77.0) and 21.5 % 
      (95 % CI, 14.2-31.2), respectively. The rate of AEs was 17.2 % (95 % CI, 
      13.1-22.2) with most common AE being dysphagia/esophageal stricture followed by 
      bleeding with rates of 11.4 % and 5.0 %, respectively. GERD health-related 
      quality of life (GERD-HRQL) (mean difference [MD] = 14.9, P  < 0.001), GERD 
      questionnaire (GERD-Q) (MD = 4.85, P  < 0.001) and mean acid exposure time 
      (MD = 2.39, P  = 0.01) decreased significantly post-ARMS as compared to 
      pre-procedure. There was no difference in terms of clinical response and AEs 
      between ARMS and ARMS with banding on subgroup analysis. Conclusions  ARMS is a 
      safe and effective procedure for treatment of refractory GERD with high rates of 
      clinical response, acceptable safety profile and significant improvement in 
      GERD-related quality of life. Prospective studies are needed to validate our 
      findings.
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 - Garg, Rajat
AU  - Garg R
AD  - Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and 
      Surgery Institute; Cleveland Clinic, Cleveland, Ohio, United States.
FAU - Mohammed, Abdul
AU  - Mohammed A
AD  - Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio, United 
      States.
FAU - Singh, Amandeep
AU  - Singh A
AD  - Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and 
      Surgery Institute; Cleveland Clinic, Cleveland, Ohio, United States.
FAU - Schleicher, Mary
AU  - Schleicher M
AD  - Cleveland Clinic Alumni library, Cleveland Clinic, Cleveland, Ohio, United 
      States.
FAU - Thota, Prashanthi N
AU  - Thota PN
AD  - Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and 
      Surgery Institute; Cleveland Clinic, Cleveland, Ohio, United States.
FAU - Rustagi, Tarun
AU  - Rustagi T
AD  - Department of Gastroenterology and Hepatology, University of New Mexico, 
      Albuquerque, New Mexico, United States.
FAU - Sanaka, Madhusudhan R
AU  - Sanaka MR
AD  - Department of Gastroenterology, Hepatology and Nutrition, Digestive Diseases and 
      Surgery Institute; Cleveland Clinic, Cleveland, Ohio, United States.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220610
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC9187426
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2022/06/14 06:00
MHDA- 2022/06/14 06:01
PMCR- 2022/06/01
CRDT- 2022/06/13 03:07
PHST- 2021/08/23 00:00 [received]
PHST- 2021/11/15 00:00 [accepted]
PHST- 2022/06/13 03:07 [entrez]
PHST- 2022/06/14 06:00 [pubmed]
PHST- 2022/06/14 06:01 [medline]
PHST- 2022/06/01 00:00 [pmc-release]
AID - 10.1055/a-1802-0220 [doi]
PST - epublish
SO  - Endosc Int Open. 2022 Jun 10;10(6):E854-E864. doi: 10.1055/a-1802-0220. 
      eCollection 2022 Jun.