Mahmood Z, McMahon B P, Arfin Q, Byrne P J, Reynolds J V, Murphy E M, Weir D G
Department of Clinical Medicine, Trinity College, St James's Hospital, Dublin, Ireland.
Gut. 2003 Jan;52(1):34-9. doi: 10.1136/gut.52.1.34.
Gastro-oesophageal reflux disease (GORD) is, in the main, treated with either proton pump inhibitor (PPI) drugs or a Nissen fundoplication operation. Recently, BARD developed Endocinch, a device used to place sutures just below the oesophagogastric junction (OGJ) to treat GORD.
To evaluate the long term benefit of the Endocinch technique in patients seen up to 12 months post procedure.
Twenty six patients with symptoms of GORD were recruited and had the procedure performed. Four patients were lost to follow up.
Twenty two patients completed their one year follow up. Pre procedure and post procedure (up to 12 months) assessments included symptom scoring (DeMeester), upper intestinal endoscopy, oesophageal manometry and 24 hour oesophageal pH, and completion of quality of life (QOL) questionnaires.
Mean age was 39 years (range 22-62). Heartburn symptom score was reduced from a mean value of 19.22 at baseline to 7.5 at 12 months (n=22) (p<0.0001). Regurgitation score reduced from a mean of 2.27 at baseline to 0.86 at 12 months (n=22) (p<0.001). Mean (SEM) pH DeMeester acid score was reduced from 44.1 (4.3) to 33.32 (4.73) (p=0.028) at three month post procedure. Percentage upright acid exposure and number of reflux episodes were also reduced significantly. Use of PPIs was reduced by 64% at 12 months post procedure. All QOL assessments showed significant improvement (p=0.01). All transient post procedure complaints resolved within 72 hours.
The Endocinch procedure is an effective and safe outpatient procedure that offers GORD patients significant improvement in symptomatology, QOL, and reduced requirements for PPIs over at least a one year period.
胃食管反流病（GORD）主要通过质子泵抑制剂（PPI）药物或nissen胃底折叠术进行治疗。最近，巴德公司研发了Endocinch，一种用于在食管胃交界处（OGJ）下方放置缝线以治疗GORD的装置。
评估Endocinch技术在术后长达12个月的患者中的长期益处。
招募了26名有GORD症状的患者并进行了该手术。4名患者失访。
22名患者完成了一年的随访。术前和术后（长达12个月）评估包括症状评分（DeMeester）、上消化道内镜检查、食管测压和24小时食管pH值，以及完成生活质量（QOL）问卷。
平均年龄为39岁（范围22 - 62岁）。烧心症状评分从基线时的平均值19.22降至12个月时的7.5（n = 22）（p < 0.0001）。反流评分从基线时的平均值2.27降至12个月时的0.86（n = 22）（p < 0.001）。术后三个月，平均（SEM）pH DeMeester酸评分从44.1（4.3）降至33.32（4.73）（p = 0.028）。直立位酸暴露百分比和反流发作次数也显著减少。术后12个月，PPI的使用减少了64%。所有QOL评估均显示有显著改善（p = 0.01）。所有术后短暂出现的不适在72小时内均得到缓解。
Endocinch手术是一种有效且安全的门诊手术，至少在一年时间内，能使GORD患者的症状、QOL得到显著改善，对PPI的需求减少。
