Feretis C, Benakis P, Dimopoulos C, Dailianas A, Filalithis P, Stamou K M, Manouras A, Apostolidis N
Department of Therapeutic Endoscopy and the Department of Internal Medicine, "Hygeja" Hospital, Athens, Greece.
Gastrointest Endosc. 2001 Apr;53(4):423-6. doi: 10.1067/mge.2001.113912.
A gelatinous implant containing polymethylmethacrylate (PMMA) beads is successfully used to augment the diminished thickness of the chorium in patients with skin defects and wrinkles. The aim of the present study was to determine whether submucosal injection of PMMA microspheres into the lower esophageal folds decreases the severity of symptoms and acid reflux in patients with GERD.
Endoscopic submucosal implantation of PMMA was carried out in 10 patients with GERD who were either refractory to or dependent on proton pump inhibitors. Symptom severity score, 24-hour pH monitoring, upper GI endoscopy, and EUS were performed to evaluate the efficacy of implantation.
A significant decrease in the symptom severity score and mean total time with esophageal pH less than 4 was noted after the implantation of PMMA (p < 0.05). Seven of 10 patients were taking no medication after PMMA implantation. There were no serious procedure-related complications.
Endoscopic implantation of PMMA into the submucosa of the lower esophageal folds may be a new method for treating GERD. Further studies are required to determine the long-term efficacy of the procedure.
一种含有聚甲基丙烯酸甲酯（PMMA）微珠的凝胶状植入物已成功用于增加皮肤缺损和皱纹患者变薄的真皮厚度。本研究的目的是确定在下段食管皱襞处黏膜下注射PMMA微球是否能减轻胃食管反流病（GERD）患者的症状严重程度和胃酸反流情况。
对10例对质子泵抑制剂难治或依赖的GERD患者进行了内镜下黏膜下PMMA植入术。通过症状严重程度评分、24小时pH监测、上消化道内镜检查和超声内镜检查来评估植入的疗效。
植入PMMA后，症状严重程度评分以及食管pH值小于4的平均总时长显著降低（p < 0.05）。10例患者中有7例在植入PMMA后无需服药。未出现与手术相关的严重并发症。
内镜下将PMMA植入下段食管皱襞的黏膜下可能是一种治疗GERD的新方法。需要进一步研究来确定该手术的长期疗效。
