Abstract
The key advantages of endoscopic treatment of refractory gastroesophageal reflux disease are that it is less invasive and has less adverse events. Nissen fundoplication has long been considered the gold standard for antireflux surgery. However, it leads to adverse events such as dysphagia, gas bloating, and inability to belch, and 15–30% of patients require re-intervention after surgery. Currently, there are three categories of currently available endoscopic treatments of refractory gastroesophageal reflux disease: endoscopic devices for ablative therapy, gastric fundoplication, and mucosal resection of the gastroesophageal junction (GEJ) which we introduce in this chapter. Stretta utilizes radiofrequency therapy to improve the lower esophageal sphincter (LES) function. Transoral incisionless fundoplication (TIF) was developed to mimic antireflux surgery by constructing a valve at the GEJ. TIF reconfigures the tissue to obtain a full-thickness gastroesophageal valve from inside the stomach, by serosa-to-serosa plications that include the muscle layers. Mucosectomy was based on the principle that after mucosal resection, mucosal healing results in scar formation.
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Yoo, I.K., Cho, J.Y. (2019). Endoscopic Treatment of Refractory Gastroesophageal Reflux Disease. In: Chun, H., Yang, SK., Choi, MG. (eds) Therapeutic Gastrointestinal Endoscopy. Springer, Singapore. https://doi.org/10.1007/978-981-13-1184-0_24
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DOI: https://doi.org/10.1007/978-981-13-1184-0_24
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