Randomized Controlled Trial: The Clinical Efficacy and Safety of Transoral Endoscopy Cardia Coarctation With Ligation versus Proton Pump Inhibitors for the Treatment of Gastroesophageal Reflux Disease

Abstract

Introduction: Transoral endoscopy cardia coarctation (TECC) has been developed as a new alternative endoscopic treatment for gastroesophageal reflux disease (GERD). This study evaluated the clinical benefit of TECC for controlling GERD symptoms, esophageal acid exposure, esophagitis and quality of life, compared with proton pump inhibitors (PPIs). Methods: Transoral endoscopy cardia coarctation (TECC) has been developed as a new alternative endoscopic treatment for gastroesophageal reflux disease (GERD). This study evaluated the clinical benefit of TECC for controlling GERD symptoms, esophageal acid exposure, esophagitis and quality of life, compared with proton pump inhibitors (PPIs). Results: A total of 100 patients (TECC, n=60; PPI, n=40) were included in the analysis. DeMeester scores improved more in the TECC group than did those in the PPI group (P<0.001) at 6 months, with no significant difference in esophagitis decrease compared with baseline endoscopy (P=0.268). At 6 (n=60) and 12 (n=54) months after TECC, DeMeester scores showed a significant improvement compared with baseline measurements (P=0.025). Conclusion: TECC is more effective than PPI treatment in controlling GERD symptoms, esophageal acid exposure, and LES pressure according to this short-term analysis. With considerable security and economic efficiency, TECC endoscopically created an anti-reflux barrier with ligated rings and can be an effective supplementary treatment to laparoscopic fundoplication.353_A Figure 1 No Caption available.353_B Figure 2 No Caption available.