Shiwaku Hironari, Shiwaku Akio, Irie Hisatoshi, Akasaki Takayuki, Sato Seiya, Koreeda Nobuhiko, Shirakabe Katsudai, Yamauchi Kosuke, Inoue Haruhiro, Hasegawa Suguru
Department of Gastroenterological Surgery Fukuoka University Faculty of Medicine Fukuoka Japan.
Digestive Diseases Center Showa University Koto Toyosu Hospital Tokyo Japan.
DEN Open. 2025 May 7;6(1):e70134. doi: 10.1002/deo2.70134. eCollection 2026 Apr.
Endoscopic antireflux therapy is a novel endoscopic treatment for refractory gastroesophageal reflux disease. We developed antireflux myoplasty (AR-MP), a modified version of antireflux mucoplasty (ARM-P), in which exposed bilateral sling fibers are sutured directly via endoscopic hand-suturing. AR-MP was performed on a 60-year-old man, resulting in symptomatic improvement and allowing discontinuation of acid-suppressive medication 3 months after the procedure. One month postoperatively, endoscopy showed an improvement in the Hill classification from grade 3 to grade 1. Before AR-MP, endoscopic pressure study integrated system findings showed a maximum intragastric pressure value of 13.7 mmHg, indicating a flat pattern. After AR-MP, maximum intragastric pressure exceeded 20 mmHg, and the pattern shifted to uphill. AR-MP is an innovative endoscopic technique that reconstructs the native antireflux mechanism by suturing the sling fibers and reforming the gastroesophageal flap valve. This innovative endoscopic procedure, like ARM-P, provides immediate symptom relief and represents a breakthrough in the endoscopic treatment of gastroesophageal reflux disease.
内镜抗反流治疗是一种针对难治性胃食管反流病的新型内镜治疗方法。我们开发了抗反流肌成形术（AR-MP），它是抗反流黏膜成形术（ARM-P）的改良版本，通过内镜手工缝合直接缝合暴露的双侧吊带纤维。对一名60岁男性实施了AR-MP，术后症状改善，术后3个月可停用抑酸药物。术后1个月，内镜检查显示希尔分级从3级改善至1级。在进行AR-MP之前，内镜压力研究综合系统结果显示胃内最大压力值为13.7 mmHg，呈平坦模式。AR-MP术后，胃内最大压力超过20 mmHg，模式转变为上升型。AR-MP是一种创新的内镜技术，通过缝合吊带纤维和重塑胃食管瓣阀来重建天然抗反流机制。这种创新的内镜手术与ARM-P一样，能立即缓解症状，代表了胃食管反流病内镜治疗的一项突破。
