International Medical Center Jeddah, Makkah, Saudi Arabia
Mazin Alsayed, MBBS, Roaa Ali. Joudah, MBBS, Abrar Mohamed. Khalil, MBBS, Adeeb Elghalayini, MD, Harith Baharith, MD International Medical Center, Jeddah, Makkah, Saudi Arabia
Introduction: There have been many devices to treat reflux disease endoscopically. These Devices are found to be effectively controlling reflux with lower risk and faster recovery. In this study we assessed the efficacy and safety of endoscopic full-thickness plication using GERDx™ device in patients with refractory gastroesophageal reflux (GERD).
Methods: We conducted a Retrospective chart review of outpatient records from December 2021 to January 2023 at international medical center, Jeddah, Saudi Arabia to identify patients underwent endoscopic full-thickness plication. We recorded demographics and endoscopic findings of selected patients. We assess safety by recording post-procedural length of stay, readmission, and complications. We reviewed efficacy by clinical resolution and discontinuation of proton pump inhibitors.
Results: 36 patients were included in the analysis. More than 80 % of patients included in the study were males, with duration of reflux symptoms and PPI use more than 1 year. There was no significant endoscopic evidence of esophagitis; and/or Barrett's esophagus in patients underwent the procedure. Most of the patients underwent the procedure with endoscopic findings of 2 - 3 cm hiatal hernia. Nearly 80 % of patients are discharged after 1 day of hospital stay. One patient only developed perforation after the procedure, which was managed conservatively. More than half (55.56 %) of patients included in the study achieved clinical resolution with successful discontinuation of PPI.
Discussion: In our small study, we found that endoscopic full-thickness plication using GERDx™ devicewas effective in controlling reflux symptoms as well as eliminating PPI use in almost half of our patients. Safety outcomes were favorable with only one case developed perforation after the procedure which did recover completely.
Table
Patients characteristics
Gender
Male
Female
29 (80.56%)
7 (19.44%)
Age
18-25 years
26-35 years
36-45 years
46-55years
56-65 years
2 (5.56%)
9 (25%)
6 (16.67%)
8 (22.22%)
11 (30.56%)
BMI
< 40
>40
33 (91.67%)
3 (8.33%)
History of smoking
Yes
no
10 (27.78%)
26 (72.22%)
Duration of reflux
1 years
2-3 years
4-5 years
>5 years
3 (8.33%)
10 (27.78%)
13 (36.11%)
9 (25%)
Duration of PPI use
< 1 year
1-5 years
6-10 years
>10 years
2 (5.56%)
24 (66.67%)
6 (16.67%)
3 (8.33%)
Endoscopic findings
Size of hiatus hernia
1 cm
2 cm
3 cm
9 (25%)
16 (44.44%)
11 (30.56%)
Evidence of esophagitis
Yes
No
8 (22.22%)
28 (77.78%)
Barrett’s esophagus
Yes
No
1 (2.78%)
35 (97.22%)
Admission status
Length of stay
1 day
>1 day
30 (83.33%)
6 (16.67%)
Readmission
Yes
No
3 (8.33%)
33 (91.67%)
Clinical response
Using PPI
Yes
No
16 (44.44%)
20 (55.56%)
Post plication complications
Perforation
1
(2.78%)
Pain
6
(16.67%)
Sepsis
0
(0%)
Fever
0
(0%)
*BMI: body mass index, PPI: proton pump inhibitor
Disclosures:
Mazin Alsayed indicated no relevant financial relationships.
Roaa Joudah indicated no relevant financial relationships.
Abrar Khalil indicated no relevant financial relationships.
Adeeb Elghalayini indicated no relevant financial relationships.
Harith Baharith indicated no relevant financial relationships.
Mazin Alsayed, MBBS, Roaa Ali. Joudah, MBBS, Abrar Mohamed. Khalil, MBBS, Adeeb Elghalayini, MD, Harith Baharith, MD. P3267 - Outcomes of Endoscopic Full-thickness Plication Devices for Patients With GERD: A Retrospective Study, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
