Rothstein Richard I, Filipi Charles J
Section of Gastroenterology Dartmouth Hitchcock Medical Center, One Medical Drive, Lebanon, NH 03756, USA.
Gastrointest Endosc Clin N Am. 2003 Jan;13(1):89-101. doi: 10.1016/s1052-5157(02)00107-1.
From a review of the single peer reviewed published report and the brief preliminary studies presented in abstract form, the BARD EndoCinch procedure seems safe and demonstrates an acceptable efficacy for symptom control during short-term follow-up. Most patients (about 2 out of 3) do well with improvement of GERD symptoms during the first post-procedural year. This benefit may wane over time. Objective benefit is lacking with the minority of treated individuals achieving normalization of 24-hour total acid exposure, and no significant effect has been seen in healing of esophagitis. This may focus the treatment towards that group of GERD patients with mild or non-erosive disease. The authors have no information that the endoscopic therapy could prevent reflux-related complications, and long-term data is awaited from accumulated clinical experience to establish the maintenance profile of this novel treatment. The outcomes from the sham trial, and long-term follow-up data will help to define the role of this anti-reflux therapy. The authors need additional studies to define the effect of endoluminal plication on the function of the lower esophageal sphincter to optimize its benefit for patients.
从一篇经同行评审发表的报告以及以摘要形式呈现的简短初步研究来看，BARD EndoCinch手术似乎是安全的，并且在短期随访期间对症状控制显示出可接受的疗效。大多数患者（约三分之二）在术后第一年GERD症状有所改善，情况良好。这种益处可能会随着时间减弱。少数接受治疗的个体24小时总酸暴露未能恢复正常，缺乏客观益处，且食管炎愈合方面未见显著效果。这可能使治疗聚焦于轻度或非糜烂性疾病的GERD患者群体。作者没有信息表明内镜治疗可预防反流相关并发症，有待积累的临床经验提供长期数据以确立这种新疗法的维持情况。假手术试验的结果以及长期随访数据将有助于明确这种抗反流治疗的作用。作者需要更多研究来确定腔内折叠对食管下括约肌功能的影响，以优化其对患者的益处。
