| BackgroudGastroesophageal Reflux Disease(GERD)is a common chronic gastrointestinal motility disorder,which refers to the reflux of gastric and duodenal contents into the esophagus causing acid reflux,heartburn and other symptoms,and can also cause tissue damage in the adjacent tissues of the esophagus such as the throat and trachea,resulting in extraesophageal symptoms.In recent years,with the change of people's lifestyle and dietary habits,its prevalence has been increasing year by year worldwide.Although GERD is a benign disease,it has seriously affected people's daily life because of its recurrent symptoms,increasing incidence year by year and more complications.In recent years,with the development and progress of endoscopic technology,new endoscopes have emerged,gradually compensating for and partially replacing the traditional medical,surgical and endoscopic surgical treatment,and becoming the main treatment for refractory gastroesophageal diseases.Endoscopic cardial constriction ligation(ECCL),first published by Professor Linghu Enqiang in 2013,and Anti-reflux mucosal resection(ARMS),first invented and reported by Professor Haruhiro Inoue in Japan in 2014,uses postoperative scar tissue formation to reduce the cardia orifice,increase the pressure of the lower esophageal sphincter(LES),reduce the overrelaxation of the LES,and effectively play a role in resistance.The efficacy and safety of ARMS and ECCL in the treatment of gastroesophageal diseases have been reported in the literature at home and abroad,but the difference in efficacy between the two has not been reported.By comparing the operation time,postoperative symptom improvement rate,GERD Q score and DeMeester score,the clinical effect of the two in the endoscopic treatment of GERD was observed,thus providing a reference for the selection of endoscopic treatment of GERD.ObjectiveTo compare the clinical efficacy of anti-reflux mucosectomy and endoscopic cardial constriction ligation for the gastroesophageal reflux disease.MethodsThe clinical data of 48 patients with gastroesophageal diseases who underwent Anti-reflux mucosal resection or Endoscopic cardial constriction ligation in the First Affiliated Hospital of Zhengzhou University from December 2015 to August 2018 and were followed up regularly were retrospectively analyzed,in which 20 patients underwent Anti-reflux mucosal resection(ARMS group)and 28 patients underwent Endoscopic cardial constriction ligation(ECCL group).The clinical efficacy of the two methods was compared.Results1.The success rate of both operations was 100%,and no postoperative fever,bleeding,perforation,dysphagia and other events occurred.2.The mean operation time was 34.05±12.35 min in ARMS group,44.80 ±7.60 min in ESD group,23.30 ± 2.67 min in EMR group and 8.43±1.59 min in ECCL group;the operation time of ECCL was significantly shorter than that of ARMS group(P<0.05).3.Two months after operation,the effective rate of symptom improvement in ECCL group was significantly higher than that in ARMS group[89%(25/28)and 60%(12/20)2=4.128 P=0.042],GERD Q score was significantly lower than that in ARMS group[(6.24 ± 1.22)points and(7.35 ± 1.79)points t=-2.400 P=0.023],and the difference had statistical significance(P<0.05).One year after operation,the effective rate of symptom improvement was 82%(23/28)and 90%(18/20)],GERD Q score[(8.11±1.89)points and(7.60 ± 1.50)points],DeMeester score[(20.28±3.94)points and(17.61 ± 5.86)points],PH<4 time[(8.47±1.28)%and(7.99 ± 1.02)%]in ECCL ARMS group,and the differences had no statistical significance(P>0.05).Gastroscopy showed that the degree of cardia relaxation was significantly reduced.ConclusionBoth anti-reflux mucosectomy and endoscopic cardial constriction ligationcan effectively control the patient's symptoms,and the specific choice can be determined according to the patient's condition and the technical level of medical center. |
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