TBA (25W179)

Anti-reflux mucosectomy with banding (ARMS-B) for GORD: A pilot study

Author(s)

Ciaran Judge, Mehul Patel, Shraddha Gulati, Amyn Haji, Bu Hayee

Department(s)/Institutions

Department of Endoscopy, King's College Hospital, London

Introduction

Gastroesophageal reflux disease (GORD) is common and frequently challenging to treat. Anti-reflux mucosectomy (ARMS) techniques show promise but can be technically demanding. ARMS-B is a variant of the technique and uses a standard banding kit to apply bands in a crescentic fashion to the cardia to induce scarring.

Aims/Background

We evaluated the safety and efficacy of this novel technique.

Method

This was a single-centre, prospective cohort study. Patients with PPI-refractory, symptomatic GORD confirmed on ambulatory pH monitoring were eligible. Repeat pH monitoring was performed at 3 months. Primary outcomes included change in acid exposure time (AET), Gastroesophageal Reflux Disease Health-Related Quality of Life (GORD-HQRL) scores and adverse events. Secondary outcomes included change in PPI usage and procedure time.

Results

Thirteen patients were included in the final analysis (69.2% female; mean age 51.3 years, mean BMI 22.9). Median follow-up duration was 6.3 months (3.5 – 24). Post treatment, AET normalised in 60% (9.9% vs 5.2%, 95% CI [1.01 – 8.3], p=0.02) and GORD-HQRL scores normalised in 54.5% (34.7 vs 22.3, 95% CI [1.7 – 23], p = 0.03). 46.2% of patients ceased or reduced the dose of their PPI at 3 months. No complications were reported in early or late follow-up.

Conclusions

This pilot study demonstrates that ARMS-B is both safe and effective for the treatment of GORD. The procedure led to significant reductions in AET, GORD-HRQL, symptom control, and PPI usage. Further studies with larger cohorts and longer follow-up periods are warranted to confirm these findings.