Prospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2024; 16(10): 557-565
Published online Oct 16, 2024. doi: 10.4253/wjge.v16.i10.557
Gastric fundoplication with endoscopic technique: A novel approach for gastroesophageal reflux disease treatment
Eyad Gadour, Anna Carolina Hoff
Eyad Gadour, Department of Gastroenterology and Hepatology, King Abdulaziz Hospital-National Guard, Ahsa 31982, Saudi Arabia
Eyad Gadour, Internal Medicine, Zamzam University College, School of Medicine, Khartoum 11113, Sudan
Anna Carolina Hoff, Bariatric Endoscopy, Angioskope Clinic, São José dos Campos 12243-680, São Paulo, Brazil
Author contributions: Gadour E and Hoff AC contributed to conceptualization, resources; Hoff AC contributed to case selection, contesting and performing the procedures; Gadour E contributed to analysing the results, writing, reviewing and editing the final manuscript; Gadour E contributed to supervision; Hoff AC contributed to project administration. All authors read and agreed to the published version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Clinical Trial Ethical Committee of Clínica Angioskope Review Board and approved it. AN00172-3 in May 2023.
Clinical trial registration statement: This study is registered at Clínica Angioskope. The registration identification number is AN00172-3.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eyad Gadour, CCST, Doctor, FACP, FRCP, FRCPE, MBBS, MRCP, MSc, Associate Professor, Consultant Physician-Scientist, Department of Gastroenterology and Hepatology, King Abdulaziz Hospital-National Guard, King Abdullah Military City, Al Mubarraz, Ahsa 31982, Saudi Arabia. eyadgadour@doctors.org.uk
Received: July 19, 2024
Revised: September 10, 2024
Accepted: September 19, 2024
Published online: October 16, 2024
Processing time: 87 Days and 23 Hours
Abstract
BACKGROUND

Gastric fundoplication with endoscopic technique (GFET) is an innovative approach to managing gastroesophageal reflux disease (GERD). This minimally invasive procedure utilizes the GEN-2 Apollo endosuture device and Olympus H2T180 gastroscope to perform partial fundoplication by strategically placing Prolene 2-0 sutures at the 11, 7, 5, 1, and 3 o’clock positions around the gastroesophageal junction.

AIM

To evaluate whether GFET enhances the lower esophageal sphincter function by creating comprehensive plication to improve the barrier against reflux.

METHODS

This single-center prospective study included patients undergoing GFET. Before beginning GFET, pH metrics and subsequent manometric measurements were obtained. An analysis of variance was performed to determine statistically significant differences between quality of life (QOL) and DeMeester scores at the time of the procedure and 6 and 12 months postoperatively. Pearson’s χ2 test was performed to identify statistically significant differences between categorical variables at the time of the procedure and 6 and 12 months postoperatively.

RESULTS

Eighteen participants were enrolled (11 males and 7 females; mean age, 35 years). More than 70% had an initial Hill grade of IIb. One adverse event was recorded after the procedure. One patient underwent valve reinforcement at 12 months. The mean QOL score was markedly higher at the time of the procedure (39.9 ± 4.0) compared to those at 6 and 12 months postoperatively (P < 0.001). Scores at 12 months were slightly higher than those at 6 months. The highest mean QOL score was observed at the time of the procedure, followed by those at 6 and 12 months postoperatively (P < 0.001). A similar trend was noted for the mean DeMeester scores (P < 0.001).

CONCLUSION

GFET is a minimally invasive alternative to traditional surgical interventions and endoscopic techniques for managing GERD. Further research is warranted to validate its long-term efficacy and effectiveness over existing treatments.

Keywords: Gastric fundoplication with endoscopic technique; Gastroesophageal reflux disease; Therapeutic endoscopy

Core Tip: Gastric fundoplication with endoscopic technique (GFET) is an innovative and minimally invasive method of treating gastroesophageal reflux disease (GERD). This procedure uses the GEN-2 Apollo endosuture device and Olympus H2T180 gastroscope and involves placing sutures around the gastroesophageal junction to strengthen the lower esophageal sphincter. This technique aims to reduce reflux without surgery. Most patients experienced significant improvements in their quality of life and GERD symptoms over the course of 12 months. GFET is associated with minimal side effects; therefore, it appears to be a promising and safe option for GERD management.