胃食道逆流症（GERD）は患者の生活の質（QOL）を低下させる有病率の高い消化器疾患である．一般的に，薬物治療では十分な効果が得られない場合を難治性GERDと称する．近年では新しい内視鏡治療（ARMS，ARMA，ARM-P，ESD-Gなど）が開発され，注目を集めている．外科的には，内視鏡治療が十分でない場合には，腹腔鏡下逆流防止手術（Nissen噴門形成術など）が検討される．また，GERDの診断法においても，内視鏡的内圧測定統合システム（EPSIS）の開発により，簡便な方法で，下部食道括約筋（LES）の機能評価が可能となってきた．本セッションでは，難治性GERDの内視鏡診療に関する演題を内科および外科の両分野から広く募集し，議論を深める場としたい．

Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder with a high prevalence, often resulting in significantly reduced quality of life for patients. When standard medication does not provide adequate relief, it is referred to as refractory GERD. In recent years, new endoscopic treatments, such as ARMS (anti-reflux mucosectomy), ARMA (anti-reflux mucosal ablation), ARMP (anti-reflux mucoplasty) and ESD-G (endoscopic submucosal dissection for GERD), have been developed. From the surgical perspective, options like laparoscopic anti-reflux surgery (e.g., Nissen fundoplication) are considered when endoscopic treatments are not sufficient. Furthermore, in the diagnosis of GERD, the development of EPSIS (endoscopic pressure study integrated system) has made it possible to easily evaluate the function of the lower esophageal sphincter (LES). This session would like to provide an opportunity for deeper discussion on the endoscopic management of refractory GERD by soliciting presentations from both the fields of internal medicine and surgery.