Antireflux mucosectomy effective against treatment-refractory GERD

Patients with treatment-refractory gastroesophageal reflux disease (GERD) may find relief from antireflux mucosectomy (ARMS), suggests a study.

In addition, the researchers suggest the 2/3 circumference, 1.5-cm wide mucosal resection of the gastric cardia as the gold standard for this procedure.

In this prospective trial, the researchers randomized 32 patients with treatment-refractory GERD into group A (n=16) and group B (n=16), in which they performed a 2/3 or 1/2 circumference, 1.5-cm wide mucosal resection of the gastric cardia, respectively.

Health-related quality of life (HRQoL), frequency scale for the symptoms of GERD (FSSG), DeMeester scores, and acid exposure time (AET) were assessed at baseline and at 24 hours following treatment. Physical component summaries (PCS), mental component summaries (MCS), and RE-specific summary (RES) scores were also estimated.

All patients had successful surgical procedures, and none of them experienced bleeding, perforation, or dysphagia. The PCS, MCS, and RES scores were higher post-ARMS than pre-ARMS in both groups. The FSSG, DeMeester scores, and AET also decreased in the two groups following ARMS, with statistically significant differences (p<0.05).

Notably, the changes in PCS, MCS, RES, FSSG, DeMeester scores, and SET were higher in group A than in group B, with significant differences in PCS, MCS, RES, and FSSG scores (p<0.05), but not in DeMeester scores and AET (p>0.05).

“ARMS is an effective treatment for treatment-refractory GERD. Moreover, we recommend the 2/3 circumference, 1.5-cm wide mucosal resection of the gastric cardia,” the researchers said.