The majority of patients had complete relief of acid reflux symptoms without the need for prescription proton pump inhibitors and only rare use of antacids according to Douglas Pleskow, MD, the study’s principal investigator.
The findings, appearing in the online edition of the journal Surgical Endoscopy, demonstrate a sustained reduction in GERD symptoms and medication use three years post-procedure. GERD is a condition in which the acidic liquid content of the stomach is regurgitated, causing damage in the lining of the esophagus.
Pleskow says patients suffering from GERD can feel worse than those suffering from depression, heart attacks and even diabetes. “It affects their productivity, their employment so it’s very important to help control gastro esophageal reflux disease.”
The treatment, called endoscopic plication, uses a device called the Plicator to restore the anti-reflux barrier, “a fold over the top part of the stomach that acts to prevent acid and other stomach contents from going up into the esophagus which then reduces symptoms,” says Pleskow.
The study involved 29 patients with chronic heartburn who required daily maintenance of their symptoms with medication. Patients were treated at five sites, each receiving plication treatment. They were then evaluated for GERD symptoms and medication use 12 and 36 months after treatment.
All but one of the 29 patients in the study required daily proton pump therapy prior to the procedure. The other patient was on high dose histamine –2 antagonist therapy. Over half the medication dependant patients remained off the daily treatment at the 36 month follow-up and 50 percent were able to stop medication completely.
Pleskow initially studied the effects of plication in a larger study conducted five years ago with 64 patients. That focused primarily on the efficacy and safety of the device but included a one-year follow-up. It was then determined that a study focusing on the longer-term results of the procedure was necessary. Only 29 of the original 64 original patients were available for long term follow up.
“When we initially looked at the study, there were 59 percent of the patients who had had plication at one year completely symptom free,” Pleskow says. “What the data shows now at three years is that 55 percent of the original patient population had complete symptom relief.”
Pleskow’s goal is to look at the data again in two years. He doesn’t anticipate much drop-off in numbers. In fact with time, he anticipates better results, because this study reflects the early experience of the Plicator. As time has passed the physicians using this device have developed newer techniques at placing the sutures.
“We’re much better at performing the procedure than when we started out and the equipment we’re using now is much more advanced,” Pleskow says, adding he hopes greater availability to the general public will allow for a much larger study in the future.
In addition to Pleskow, study co-authors include BIDMC’s Anthony Lembo, MD, Richard Rothstein, MD, of Dartmouth-Hitchcock Medical Center in Lebanon, NH, Richard Kozarek, MD, of the Virginia Mason Medical Center in Seattle, Gregory Haber, MD, of Lenox Hill Hospital in New York and Christopher Gostout, MD, of the Mayo Clinic in Rochester, MN.
This study was funded by a grant from NDO Surgical, Inc. in Mansfield, MA.
Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School, and ranks third in National Institutes of Health funding among independent hospitals nationwide. BIDMC is clinically affiliated with the Joslin Diabetes Center and is a research partner of Dana-Farber/Harvard Cancer Center. BIDMC is the official hospital of the Boston Red Sox. For more information, visit www.bidmc.harvard.edu.
Zineb Marchoudi | EurekAlert!
The Great Unknown: Risk-Taking Behavior in Adolescents
19.01.2017 | Max-Planck-Institut für Bildungsforschung
A sudden drop in outdoor temperature increases the risk of respiratory infections
11.01.2017 | University of Gothenburg
An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...
Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...
Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.
While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...
Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales
Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...
Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.
As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...
19.01.2017 | Event News
10.01.2017 | Event News
09.01.2017 | Event News
19.01.2017 | Ecology, The Environment and Conservation
19.01.2017 | Awards Funding
19.01.2017 | Studies and Analyses