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Efficacy of endoluminal gastroplication in Japanese patients with proton pump inhibitor-resistant,non-erosive esophagitis

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World Journal of Gastroenterology 2012年第41期18卷 5940-5947页

作者： Kentaro Tokudome Yasushi Funaki Makoto Sasaki Shinya Izawa Yasuhiro Tamura Akihito Iida Naotaka Ogasawara Toshihiro Konagaya yoshifumi tokura Kunio Kasugai Division of Gastroenterology Department of Internal MedicineAichi Medical University School of MedicineAichi 480-1195Japan Department of clinical Laboratory Aichi Medical University School of MedicineAichi 480-1195Japan Marine clinic NagoyaAichi 460-0002Japan tokura yoshifumi stomach and intestines internal medicine clinic Kyoto 615-8256Japan

AIM:To evaluate the efficacy,safety,and long-term outcomes of endoluminal gastroplication(ELGP) in patients with proton pump inhibitor(PPI)-resistant,nonerosive reflux disease(NERD).METHODS:The subjects were NERD patients,diagnosed by upper endoscopy before PPI use,who had symptoms such as heartburn or reflux sensations two or more times a week even after 8 wk of full-dose PPI *** to ELGP,while continuing full-dose PPI medication,patients' symptoms and quality of life(QOL) were assessed using the questionnaire for the diagnosis of reflux disease,the frequency scale for symptoms of gastro-esophageal reflux disease(FSSG),gastrointestinal symptoms rating scale,a 36-item *** addition,24-h esophageal pH monitoring or 24-h intraesophageal pH/impedance(MII-pH) monitoring was *** Bard EndoCinch TM was used for ELGP,and 2 or 3 plications were *** ELGP,all acid reducers were temporarily discontinued,and medication was resumed depending on the development and severity of *** mo after ELGP,symptoms,QOL,pH or MII-pH monitoring,number of plications,and PPI medication were ***,symptoms,number of plications,and PPI medication were evaluated 12 mo after ELGP to investigate long-term ***:The mean FSSG score decreased significantly from before ELGP to 3 and 12 mo after ELGP(19.1 ± 10.5 to 10.3 ± 7.4 and 9.3 ± 9.9,P < 0.05,respectively).The total number of plications decreased gradually at 3 and 12 mo after ELGP(2.4 ± 0.8 to 1.2 ± 0.8 and 0.8 ± 1.0,P < 0.05,respectively).The FSSG scores in cases with no remaining plications and in cases with one or more remaining plications were 4.4 and 2.7,respectively,after 3 mo,and 2.0 and 2.8,respectively,after 12 mo,showing no correlation to plication *** pH monitoring,there was no difference in the percent time pH < 4 from before ELGP to 3 mo *** monitoring revealed no changes in the number of reflux episodes or the symptom index for reflux events from bef

关键词：质子泵抑制剂患者食管腔内糜烂药物治疗耐药日本

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