A Long-Term Comparison of Plication Configurations for Endoluminal Gastroplication

Abstract

To determine the long-term efficacy of endoluminal gastroplication (ELGP) and the most effective plication configuration. Endoluminal gastroplication is an intriguing therapy for gastroesophageal reflux disease. We conducted a retrospective review of a prospective experience of patient cohorts comparing outcomes of the circumferential and helical plication patterns. Twenty patients underwent ELGP, with 9 receiving the circumferential (Group 1) and 11 the helical pattern (Group 2). Manometry, endoscopy, and 24-hour pH monitoring were performed at baseline and at 6 months. Symptom scores and medication usage were assessed at baseline, 1, 3, 6, 12, and 18 months. Both groups did not differ significantly from each other with respect to symptom improvement, medication usage, or other variables measured. At 6 months, symptom scores, histamine-2 receptor antagonist (H2RA), proton pump inhibitor usage, and hernia size decreased significantly. No other parameter showed a significant change. At the 18-month follow-up, symptom scores and H2RA usage decreased significantly. ELGP improves heartburn and regurgitation scores at 18 months. Our study suggests that there is no benefit to additional plications when using the helical pattern.