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世界核心医学期刊文摘（胃肠病学分册） 2005年第1期1卷 25-25页

作者： Tuebergen D. Rijcken E. Senninger N. 李康 Department of General Surgery University of MuensterWaldeyerstrafle 1 48149 Muenster Germany

Endoscopic gastroplasty is being promoted as a new minimally invasive procedure for the treatment of gastroesophageal reflux disease. In the case presented here, however, we encountered abdominal perforation as a severe complication of this procedure. Because immediate action was taken when the symptoms developed, and by maintaining close collaboration with the surgeons, it was possible to keep the treatment minimally invasive:the leakage was detected endoscopically and the defect was closed laparoscopically and covered by a *** experience emphasises the importance of appropriate management of complications as part of the evaluation of new endoscopic methods.

关键词：食管穿孔 endocinch 缝合术腔镜胃成形术腹段食管破裂口胃食管反流外科医生内窥镜检查

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内镜缝合装置在胃食管反流病中的使用:继endocinch腔内胃折叠术后又一个失败

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世界核心医学期刊文摘（胃肠病学分册） 2005年第11期1卷 23-23页

作者： Schiefke I. Neumann S. Zabel-Langhennig A. K. Caca 尹勇 Department of Medicine II University of Leipzig Philipp-Rosenthal Str. 27 04103 Leipzig Germany Dr.

Background: Endoluminal gastroplication, using the Endo- Cinch procedure, has emerged as a potential endoscopic antireflux therapy. Although initial results have been promising, the long-term durability of the treatment is uncertain due to suture loss. A new endoscopic suturing device, the “ ESD," has been developed that promises excellent visibility and endoscopic control. at The aim of this study was to evaluate prospectively the feasibility and efficacy of the ESD method after endocinch failure. Methods: The study involved 20 patients with gastroesophageal reflux disease (GERD), who had been initially treated with an endocinch procedure, but had relapsed after a median of 7.5 months, with lost or dysfunctional sutures and with reflux symptoms that required proton pump inhibitor (PPI) treatment. Using the ESD, at least three plications were created at the gastroesophageal junction. Patients underwent endoscopy, 24-hour pH monitoring and esophageal manometry before treatment and 6 months afterwards. In addition, reflux symptoms as well as quality-of-life scores were assessed (using the SF-6 and GERD-HRQL scales). Results: The ESD procedure (median procedure time 45 min) was performed successfully in all patients without major complications. After 6 months only one patient (5% ) still had all sutures in situ, while no remaining sutures could be detected in 3/20 (15% ). No significant changes in reflux esophagitis; 24-hour pH monitoring results (median pH< 4/24 h 9.9% vs. 12.3% ; P = 0.60);manometry findings (median lower esophageal sphincter pressure 7.2 mm Hg vs. 9.9 mm Hg; P = 0.22); PPI use; or reflux esophagitis could be detected after 6 months. While reflux symptoms improved (heartbu-rn severity score 30 vs. 48, P < 0,05), no changes in quality-of-life scores were detected. Conclusions: Endoluminal gastroplication using the ESD is an easy and safe, but unfortunately ineffective procedure for endoscopic GERD treatment. Endoluminal gastroplication techniques clea

关键词：胃折叠术 endocinch 胃食管反流食管测压反流症状食管下括约肌反流性食管炎胃灼热严重度功能不良

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Four-year follow-up of endoscopic gastroplication for the treatment of gastroesophageal reflux disease

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2013年第4期4卷 120-126页

作者： Matthijs P Schwartz J Rieneke C Schreinemakers André J P M Smout Department of Gastroenterology Meander Medical Center Department of Gastroenterology University Medical Center

AIM:To evaluate the long-term effect of endocinch treatment for gastroesophageal reflux disease(GERD).METHODS:After unblinding and crossover,50 patients(32 males,18 females; mean age 46 years) with pH-proven chronic GERD were recruited from an initial randomized,placebo-controlled,single-center study,and included in the present prospective open-label follow-up ***,three gastroplications using the endocinch device were placed under deep sedation in a standardized *** retreatment was offered in the first year with 1 or 2 extra *** baseline,3 mo after(re) treatment and yearly proton pump inhibitor(PPI) use,GERD symptoms,quality of life(QoL) scores,adverse events and treatment failures(defined as:patients using > 50% of their baseline PPI dose or receiving alternative antireflux therapy) were ***-to-treat analysis was ***:Median follow-up was 48 mo [interquartile range(IQR):38-52].Three patients were lost to *** 44% of patients retreatment was done after a median of 4 mo(IQR:3-8).No serious adverse events *** the end of follow-up,symptom scores and4 out of 6 QoL subscales were improved(all P < 0.01compared to baseline).However,80% of patients required PPIs for their GERD ***,64% of patients were classified as treatment *** 60% a post-procedural endoscopy was carried out,of which in 16% reflux esophagitis was ***:In the 4-year follow-up period,the subset of GERD patients that benefit from endoscopic gastroplication kept declining gradually,nearly half opted for retreatment and 80% required PPIs eventually.

关键词： Endoscopic therapy endocinch Gastroesophageal Reflux Gastroplication Follow-up studies

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Peroral endoscopic reduction of dilated gastrojejunal anastomosis after bariatric surgery: Techniques and efficacy

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World Journal of Gastrointestinal Endoscopy 2016年第4期8卷 239-243页

作者： Kinesh Changela Emmanuel Ofori Sushil Duddempudi Sury Anand Shashideep Singhal Division of Gastroenterology the Brooklyn Hospital Center-Clinical Affiliate of Mount Sinai Hospital Division of Gastroenterology Hepatology and Nutrition University of Texas Health Science Center at Houston

AIM: To investigate the techniques and efficacy of peroral endoscopic reduction of dilated gastrojejunal anastomosis after bariatric ***: An extensive English language literature search was conducted using Pub Med, MEDLINE, Medscape and Google to identify peer-reviewed original and review articles using the keywords "bariatric endoscopic suturing", "overstitch bariatric surgery", "endoscopic anastomotic reduction", "bariatric surgery", "gastric bypass", "obesity", "weight loss". We identified articles describing technical feasibility, safety, efficacy, and adverse outcomes of overstitch endoscopic suturing system for transoral outlet reduction in patients with weight regain following Roux-en-Y gastric bypass(RYGB). All studies that contained material applicable to the topic were considered. Retrieved peer-reviewed original and review articles were reviewed by the authors and the data extracted using a standardized collection tool. Data were analyzed using statistical analysis as percentages of the event. RESULTS: Four original published articles which met our search criteria were pooled. The total number cases were fifty-nine with a mean age of 46.75 years(34-63 years). Eight of the patients included in those studies were males(13.6%) and fifty-one were females(86.4%). The mean time elapsed since the primary bypass surgery was 5.75 years. The average pre-endoscopic procedure body mass index(BMI) was 38.68(27.5-48.5). Mean body weight regained post-RYGB surgery was 13.4 kg from their post-RYGB nadir. The average pouch length at the initial upper endoscopy was 5.75 cm(2-14 cm). The pre-intervention anastomotic diameter was averaged at 24.85 mm(8-40 mm). Average procedure time was 74 min(50-164 min). Mean post endoscopic intervention anastomotic diameter was 8 mm(3-15 mm). Weight reduction at 3 to 4 mo post revision noted to be anaverage of 10.1 kg. Average overall post revision BMI was recorded at 37.7. The combined technical and clinical success rate was

关键词： Endoscopic anastomosis reduction Bariatricsurgery Endoscopic suturing endocinch Overstitchbariatric surgery

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