| Featured Session 1 (JGES,JSGE,JSGS) |
| Fri. November 1st 9:00 - 11:00 Room 1: Kobe International Exhibition Hall No.2 Building Hall (North) |
| Advances in endoscopic treatment for proton pump inhibitor refractory gastroesophageal reflux disease | |||
| Ippei Tanaka1, Haruhiro Inoue1, Yuto Shimamura1 | |||
| 1Digestive Diseases Center, Showa University Koto Toyosu Hospital | |||
|
|||
|
|||
| Gastroesophageal reflux disease (GERD) is not only common in Japan but also worldwide, with treatment primarily relying on medications such as proton pump inhibitor (PPI) and potassium-competitive acid blockers (Pcab). However, for cases where PPIs or Pcab fail to provide relief, surgical intervention has been the only option. In order to address this gap, we have developed endoscopic treatments for PPI-refractory GERD as a less invasive alternative. Initially, we reported on Anti-reflux Mucosectomy (ARMS) in 2014, which involved resecting the mucosa around the cardia using a snare. Subsequently, this treatment evolved into Anti-reflux Mucosal Ablation (ARMA), which simplified the procedure by solely ablating the mucosa. However, both treatments presented challenges such as unpredictable extent of ulcer shrinkage and post-operative bleeding of approximately 5%. Therefore, we further evolved the treatment to Anti-reflux Mucosal Plasty (ARMP), which involves resecting a third of the mucosa around the cardia and closing the ulcer. Previously, ulcer closure post-resection was challenging, but the introduction of Mantis clip has made this procedure technically simple and easy. Furthermore, by eliminating dead space technique, secure closure of the defect was successfully achieved. In this video session, we will provide a comprehensive overview of endoscopic treatment for PPI-refractory GERD, including ARMS, ARMA, and ARMP, and discuss their indications and actual techniques. |
|||
|
Index Term 1: Gastroesophageal reflux disease Index Term 2: Endoscopic treatment |
|||
| Page Top | |||