| Objective: To assess the efficacy and safety ofa new method of endoscopictherapy-Peroral Endoscopic Cardial Constriction(PECC)for gastroesophageal reflux disease(GERD).Methods:A prospective study was conducted in 42 GERD patients who had undergone PECC from August 2017 to August 2018 in the Affiliated Hospital of Inner Mongolia Medical University.Comparing the relevant evaluation indexes before and 6 months after operation use to evaluate the efficacy and safety of PECC.Efficacy evaluation indexes include Gastro-Esophageal Reflux Disease –Health Related Quality of Life(GERD-HRQL)and Gastro-Esophageal Reflux Disease – Questionnaires(GERD-Q)Scores,proton pump inhibitors(PPIs)use,endoscopy,24-hour esophageal p H and esophageal motility tests.Safety evaluation index refers to the complications of patients during and after operation.Results:A total of 42 patients with gastroesophageal reflux disease who met the inclusion and exclusion criteria were successfully treated by PECC in the Affiliated Hospital of Inner Mongolia Medical University,one of whom had no significant improvement in postoperative symptoms,he was rejected after more than 2 weeks of self-administration of PPIs,and 2patients failed to follow up for reexamination 6 months after operation.A total of 39 patients were followed up for 6 months.Comparison of clinical effect before and 6 months after operation:the symptoms and quality of life of the patients were significantly improved,score of GERD-HRQL,GERD-Q was significantly reduced(GERD-HRQL score decreased from(21.39±4.86)points before operation to(2.71±3.64)points after 6 months,and the decrease was statistically significant;GERD-Q score decreased from(13.64±2.06)points before operation to(2.71±3.64)points after 6 months,and the decrease was statistically significant);patients were satisfied with the effect of operation [26(66.67%)were satisfied with the effect of operation,10(25.64%)were generally satisfied with the effect of operation,3(7.69%)were not satisfied with the effect of operation];the follow-up of endoscopy showed that the patients' esophageal inflammation was obviously improved,and the relaxation of cardia was better than before;the 24-hour esophageal p H monitoring showed that the percentage of p H <4 time,the number of acid reflux,the time of long reflux and the number of long reflux were significantly lower than those before operation [the percentage of p H < 4 time decreased from(15.09 ± 4.36)% before operation to(4.04 ± 2.59)%,the number of acid reflux before operation was(147.78 ± 63.24),after operation to(28.90 ± 16.23),the number of long reflux before operation was(9.39 ± 3.09),and after operation was(2.13 ± 1.89),the long reflux time decreased from(25.52 ± 12.13)minutes to(10.00 ± 7.65)minutes after operation,and the De Meester score decreased from(67.41 ± 41.94)to(13.69 ± 8.83)before operation,all of the above data were statistically significant(P < 0.05);The follow-up of esophageal motility test showed that,the mean resting pressure,length and residual pressure of the lower esophageal sphincter increased slightly compared with the baseline,but there was no significant difference(P > 0.05).There were no serious treatment-related complications and death cases during and after the operation.One patient felt slight pain after sternum operation.A total of15(38.46%)patients had postoperative sternal pain,and 6(15.38%)patients had a feeling of contraction under xiphoid process or after sternal operation.The degree of discomfort was relatively low,and all patients relieved themselves within 2 weeks.Conclusions: Peroral Endoscopic Cardial Constriction provides a new,effective and safe choice for the treatment of gastroesophageal reflux disease. |
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