[Progress in endoscopic antireflux procedures].

Abstract

Gastroesophageal reflux disease (GERD) is a widespread morbid condition that adversely affects quality of life and results in great utilization of healthcare resources. Recently medical therapy has improved with the introduction of the proton pump inhibitors, but patients must take medicine rather indefinitely often on a daily basis. Surgical therapy with the application of laparoscopic fundoplication has improved too, but still is associated with invasiveness and morbidity. Now third option has emerged--endoscopic antireflux procedures. Three novel forms of endoscopic procedures are under development: plication of the gastroesophageal junction by endoscopic suturing, thermoablation of the muscle of lower esophageal sphincter and gastric cardia (the Stretta procedure), endoscopic implantation of a biopolymer (Enteryx). These procedures seem effective and rather safe, but they are in the early stages of development and the magnitude of their efficacy is yet undetermined. It is necessary to validate these methods and assess safety by long-term placebo-controlled studies.