Analysis Of The Efficacy And Safety Of Transoral Endoscopic Cardiac Contraction In The Treatment Of Gastroesophageal Reflux Disease With Esophageal Hiatal Hernia

Objective: To analyze the efficacy and safety of transoral endoscopic cardioconstriction in the treatment of GERD with esophageal hiatal hernia.Methods:A retrospective study was conducted on 28 GERD patients who met the requirements of transoral endoscopic cardioplasty in the Department of Gastroenterology of the second Hospital of Hebei Medical University from July 2019 to September 2020.The scores of gastroesophageal reflux disease questionnaire,the gastro-esophageal reflux disease-health related quality of life,the degree of remission and the use of PPI were compared between 1 day before operation and 1 month,3 months and 6 months after treatment,and the occurrence of intraoperative and postoperative complications were observed.Results:1.Compared with 1 day before operation,GERD-Q score decreased 1month(t=25.117,P < 0.001),3 months(t=24.706,P < 0.001),6 months(t=20.853,P < 0.001),and GERD-HRQL score decreased 1 month(t=34.900 P < 0.001),3 months(t=39.172,P < 0.001),6 months(t=32.218,P < 0.001),and the difference was statistically significant.The patients’ GERD-Q scores at 1,3 and 6 months after surgery were pairwise compared,and the P values were all greater than 0.05,the difference was not statistically significant.The patients’ GERD-HRQL scores at 1,3 and 6 months after surgery were pairwise compared,and the P values were all greater than 0.05,the difference was not statistically significant.2.The basic cure rates at 1 month,3 months and 6 months after operation were 96.4%,92.9% and 82.1%,respectively.3.19 patients(67.9%)stopped using PPI,while 9(32.1%)patients took oral PPI,intermittently or reduced.No patients continued to take the original dose or higher dose of oral PPI,and the removal rate of PPI was 100%.4.Of the 28 patients,8(28.5%)had choking after eating,3(10.7%)had abdominal distension,and 2(3.5%)had retrosternal pain.All the above complications were relieved or disappeared after self-observation or symptomatic treatment for 2 week.Conclusions:Transoral endoscopic cardioconstriction is maybe effective,safe and minimally invasive in the treatment of gastroesophageal reflux disease,especially for patients with esophageal hiatal hernia with hiatal hernia.It is worthy of further clinical application and promotion.