Gadour Eyad, Hoff Anna Carolina
Department of Gastroenterology and Hepatology, King Abdulaziz Hospital-National Guard, Ahsa 31982, Saudi Arabia.
Internal Medicine, Zamzam University College, School of Medicine, Khartoum 11113, Sudan.
World J Gastrointest Endosc. 2024 Oct 16;16(10):557-565. doi: 10.4253/wjge.v16.i10.557.
Gastric fundoplication with endoscopic technique (GFET) is an innovative approach to managing gastroesophageal reflux disease (GERD). This minimally invasive procedure utilizes the GEN-2 Apollo endosuture device and Olympus H2T180 gastroscope to perform partial fundoplication by strategically placing Prolene 2-0 sutures at the 11, 7, 5, 1, and 3 o'clock positions around the gastroesophageal junction.
To evaluate whether GFET enhances the lower esophageal sphincter function by creating comprehensive plication to improve the barrier against reflux.
This single-center prospective study included patients undergoing GFET. Before beginning GFET, pH metrics and subsequent manometric measurements were obtained. An analysis of variance was performed to determine statistically significant differences between quality of life (QOL) and DeMeester scores at the time of the procedure and 6 and 12 months postoperatively. Pearson's test was performed to identify statistically significant differences between categorical variables at the time of the procedure and 6 and 12 months postoperatively.
Eighteen participants were enrolled (11 males and 7 females; mean age, 35 years). More than 70% had an initial Hill grade of IIb. One adverse event was recorded after the procedure. One patient underwent valve reinforcement at 12 months. The mean QOL score was markedly higher at the time of the procedure (39.9 ± 4.0) compared to those at 6 and 12 months postoperatively ( < 0.001). Scores at 12 months were slightly higher than those at 6 months. The highest mean QOL score was observed at the time of the procedure, followed by those at 6 and 12 months postoperatively ( < 0.001). A similar trend was noted for the mean DeMeester scores ( < 0.001).
GFET is a minimally invasive alternative to traditional surgical interventions and endoscopic techniques for managing GERD. Further research is warranted to validate its long-term efficacy and effectiveness over existing treatments.
内镜技术胃底折叠术（GFET）是一种治疗胃食管反流病（GERD）的创新方法。这种微创手术利用GEN-2阿波罗内镜缝合装置和奥林巴斯H2T180胃镜，通过在胃食管交界处周围的11点、7点、5点、1点和3点位置战略性地放置2-0聚丙烯缝线来进行部分胃底折叠术。
评估GFET是否通过创建全面折叠来增强食管下括约肌功能，从而改善抗反流屏障。
这项单中心前瞻性研究纳入了接受GFET的患者。在开始GFET之前，获取pH指标和随后的测压测量值。进行方差分析以确定手术时、术后6个月和12个月时生活质量（QOL）和DeMeester评分之间的统计学显著差异。进行Pearson检验以确定手术时、术后6个月和12个月时分类变量之间的统计学显著差异。
招募了18名参与者（11名男性和7名女性；平均年龄35岁）。超过70%的患者初始希尔分级为IIb级。术后记录到1例不良事件。1例患者在12个月时接受了瓣膜强化。与术后6个月和12个月时相比，手术时的平均QOL评分明显更高（<0.001）。12个月时的评分略高于6个月时的评分。手术时观察到最高的平均QOL评分，其次是术后6个月和12个月时的评分（<0.001）。平均DeMeester评分也有类似趋势（<0.001）。
GFET是一种治疗GERD的微创替代传统手术干预和内镜技术的方法。有必要进行进一步研究以验证其相对于现有治疗方法的长期疗效和有效性。
