IDDF2023-ABS-0087 A retrospective study of peroral endoscopic cardial constriction in the treatment of gastroesophageal reflux disease with esophageal hiatal hernia

Background

To analyze the efficacy and safety of peroral endoscopic cardial constriction (PECC) for gastroesophageal reflux disease (GERD) with esophageal hiatal hernia.

Methods

A retrospective analysis was conducted on 36 patients with GERD and esophageal hiatal hernia who underwent PECC from January 2021 to June 2022 at our center. The Gastroesophageal Reflux Disease Health-Related Quality of Life (GERD-HRQL) score, symptom relief, and esophageal pH monitoring were used as evaluation indexes to assess the clinical efficacy of PECC treatment at 3 and 6 months after treatment, and the occurrence of intraoperative and postoperative complications was also recorded.

Results

No severe treatment-related complications or deaths occurred in this study. All patients successfully completed PECC treatment. The preoperative GERD-HRQL score was 20.03±1.72, while the GERD-HRQL scores at 3 and 6 months after PECC were 4.31±1.68 and 4.96±2.45, respectively. Compared with the preoperative scores, the GERD-HRQL scores after treatment significantly improved (P< .032). In terms of symptom relief, 91.7% and 83.3% of patients had almost complete symptom resolution at 3 and 6 months after PECC, respectively, while 8.3% and 13.9% had significant symptom relief, and 0% and 2.8% had partial symptom relief (P< .014). Compared with the DeMeester score before PECC, it showed a significantly decreasing trend at 3 and 6 months after treatment, with values of 129.6±87.32, 17.02±13.15, and 21.86±14.65, respectively (P< .029). Among the 36 patients, 6 (16.7%) had dysphagia, 4 (11.1%) reported mild retrosternal pain, and 1 (2.8%) had abdominal distension, which resolved or disappeared after symptomatic treatment for 2 weeks.

Conclusions

For patients with GERD and esophageal hiatal hernia, PECC can effectively control the symptoms of gastroesophageal reflux and esophageal acid exposure. It is a feasible, safe, minimally invasive, and effective treatment.