CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(04): E443-E449
DOI: 10.1055/s-0044-101453
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Initial experience with a novel resection and plication (RAP) method for acid reflux: a pilot study

Petros C. Benias
1   Zucker School of Medicine at Hofstra/Northwell
,
Lionel D’Souza
2   Mount Sinai Beth Israel, New York, New York
,
Gloria Lan
2   Mount Sinai Beth Israel, New York, New York
,
Craig Gluckman
2   Mount Sinai Beth Israel, New York, New York
,
Sumant Inamdar
1   Zucker School of Medicine at Hofstra/Northwell
,
Arvind J. Trindade
1   Zucker School of Medicine at Hofstra/Northwell
,
Larry S. Miller
1   Zucker School of Medicine at Hofstra/Northwell
,
David L. Carr-Locke
3   New York Presbyterian Cornell, New York, New York
› Author Affiliations
Further Information

Publication History

submitted 21 October 2017

accepted after revision 27 December 2017

Publication Date:
29 March 2018 (online)

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Abstract

Background and study aims Current endoscopic therapies for gastroesophageal reflux disorder (GERD) are limited by technical complexity, and/or cost. We sought to evaluate the success of a novel resection and plication (RAP) anti-reflux procedure.

Patients and methods RAP was performed on 10 patients with GERD refractory to proton pump inhibitor (PPI) therapy. RAP consists of semi-circumferential mucosectomy along with full-thickness plication of the lower esophageal sphincter (LES) and cardia. We assessed the technical success and safety as well as followed GERD-Health Related Quality of Life (GERD-HRQL) scores and medication usage.

Results All patients underwent RAP without adverse events and were discharged on the same day. Only half of the patients required general anesthesia. Follow-up ranged from 5 to 24 months (median 9 months) and all patients had a significant improvement in their GERD-HRQL scores (P < 0.0001, 95 % CI 19.3 – 25.3). 8 of 10 eliminated their daily PPI dependence.

Conclusions The RAP method has potential as an effective anti-reflux option. Its main advantages include a short procedure time, simple approach using readily available equipment, and possible avoidance of general anesthesia.