内镜下抗反流黏膜切除术治疗胃食管反流病患者:临床疗效及对肠道微生物群的影响

Endoscopic anti-reflux mucosal resection for patients with gastroesophageal reflux disease: Clinical efficacy and impact on gut microbiota.

作者信息

Han Zhe, Jiang Hai-Bo, Wang Fan-Ke, Wang Zhong-Yu, Pang Hong-Fei, Wang Yuan-Yuan, Wei Ming

机构信息

Second Department of Gastrointestinal Disease Diagnosis and Treatment, The First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei Province, China.

Department of Gastrointestinal Surgery, The First Hospital of Hebei Medical University, Shijiazhuang 050023, Hebei Province, China.

出版信息

World J Gastrointest Surg. 2025 Jun 27;17(6):103336. doi: 10.4240/wjgs.v17.i6.103336.

Abstract

BACKGROUND

In recent years, endoscopic anti-reflux mucosal resection (ARMS) has demonstrated benefits, including good efficacy, ease of operation, low cost, and fewer complications; however, it is still in the exploratory stage.

AIM

To evaluate the clinical efficacy of ARMS in patients with gastroesophageal reflux disease (GERD) and its effects on the gut microbiota.

METHODS

This single-center, retrospective, self-controlled study included 80 patients with GERD. All patients underwent endoscopic ARMS and were followed for at least 3 months after surgery. The primary outcome measures were changes in the gut microbiota before and after treatment and clinical efficacy.

RESULTS

After surgery, the counts of and were significantly lower than those before surgery ( < 0.05), whereas the counts of and were significantly higher than those before surgery ( < 0.05). Symptoms, such as reflux and heartburn, were markedly relieved postoperatively. The average Gerd Q score prior to surgery was 11.32 ± 1.26 points, which decreased to 5.89 ± 0.52 points 3 months after surgery. All patients used proton pump inhibitors before surgery, and the proportion of patients using proton pump inhibitors declined significantly postoperatively. Sixteen patients (20.0%) experienced surgery-related adverse reactions within 2 weeks to 1 month post-surgery. The incidence rates of postoperative esophageal stricture and delayed bleeding were 15.0% and 5.0%, respectively.

CONCLUSION

Endoscopic ARMS can effectively alleviate reflux symptoms, maintain gut microbiota balance, and improve gastrointestinal function in patients with GERD.

摘要

背景

近年来,内镜下抗反流黏膜切除术(ARMS)已显示出诸多益处,包括疗效良好、操作简便、成本低廉以及并发症较少;然而,它仍处于探索阶段。

目的

评估ARMS治疗胃食管反流病(GERD)患者的临床疗效及其对肠道微生物群的影响。

方法

这项单中心、回顾性、自身对照研究纳入了80例GERD患者。所有患者均接受了内镜下ARMS治疗,并在术后至少随访3个月。主要观察指标为治疗前后肠道微生物群的变化及临床疗效。

结果

术后,[具体菌种1]和[具体菌种2]的数量显著低于术前(P<0.05),而[具体菌种3]和[具体菌种4]的数量显著高于术前(P<0.05)。反流和烧心等症状在术后明显缓解。术前Gerd Q评分平均为11.32±1.26分,术后3个月降至5.89±0.52分。所有患者术前均使用质子泵抑制剂,术后使用质子泵抑制剂的患者比例显著下降。16例患者(20.0%)在术后2周内至1个月出现手术相关不良反应。术后食管狭窄和延迟出血的发生率分别为15.0%和5.0%。

结论

内镜下ARMS可有效缓解GERD患者的反流症状,维持肠道微生物群平衡,改善胃肠功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8908/12188591/67672becc407/wjgs-17-6-103336-g001.jpg

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