Journal article
Endoscopic Full‐Thickness Plication for the Treatment of Gastroesophageal Reflux Disease: A Systematic Review and Meta‐Analysis of Randomized Sham Controlled Trials
JGH open, Vol.8(11), e70056
11/2024
DOI: 10.1002/jgh3.70056
PMCID: PMC11599161
PMID: 39605898
Appears in UI Libraries Support Open Access
Abstract
Introduction
Gastroesophageal reflux disease (GERD) affects approximately 20% of adults in the United States. Proton pump inhibitors are the first-line treatment but are associated with long-term side effects. Endoscopic full-thickness plication (EFTP) is a minimally invasive alternative that improves the valvular mechanism of the gastroesophageal junction. This meta-analysis compared EFTP to a sham procedure for the treatment of refractory GERD.
Materials and Methods
This meta-analysis followed the Cochrane guidelines and PRISMA standards and was registered with PROSPERO (CRD42023485506). We searched MEDLINE, Embase, SCOPUS, and Cochrane Library through December 2023. Inclusion criteria targeted Randomized controlled trials comparing EFTP with sham procedures for GERD were included. Statistical analyses utilized RevMan with a random-effects model, and the results were considered significant at p < 0.05.
Results
Of the 2144 screened studies, three RCTs with 272 patients with GERD were included: 136 patients underwent EFTP and 136 underwent sham procedures. Primary outcomes showed a significant reduction in PPI usage (RR 0.51; 95% CI 0.35–0.73; p < 0.01) and more than 50% improvement in GERD-HRQL scores at 3 months (RR 15.81; 95% CI 1.40–178.71; p = 0.03). No significant difference was found in the DeMeester scores (MD: 12.57; 95% CI −35.12 to 9.98; p = 0.27). Secondary outcomes showed no significant difference in time with esophageal pH < 4, but a significant reduction in total reflux episodes.
Conclusions
EFTP significantly reduced PPI usage, improved GERD-HRQL scores, and decreased total reflux episodes compared with sham procedures, highlighting its potential as a minimally invasive treatment. Further research is needed to compare EFTP with other minimally invasive techniques to determine the most effective treatment option.
Details
- Title: Subtitle
- Endoscopic Full‐Thickness Plication for the Treatment of Gastroesophageal Reflux Disease: A Systematic Review and Meta‐Analysis of Randomized Sham Controlled Trials
- Creators
- Muhammad Shahzil - Weiss Memorial HospitalAmmad Javaid Chaudhary - Henry Ford HospitalAli Akram Qureshi - King Edward Medical UniversityFariha Hasan - Cooper University HospitalMuhammad Saad Faisal - Henry Ford HospitalAbdullah Sohail - University of IowaMuhammad Ali Khaqan - John H. Stroger, Jr. Hospital of Cook CountyTaher Jamali - Henry Ford HospitalMuhammad Zarrar Khan - Henry Ford HospitalEva Alsheik - Henry Ford HospitalTobias Zuchelli - Henry Ford Hospital
- Resource Type
- Journal article
- Publication Details
- JGH open, Vol.8(11), e70056
- Publisher
- Wiley; HOBOKEN
- DOI
- 10.1002/jgh3.70056
- PMID
- 39605898
- PMCID
- PMC11599161
- ISSN
- 2397-9070
- eISSN
- 2397-9070
- Language
- English
- Date published
- 11/2024
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984750663402771
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