Endoluminal gastroplication in children with significant gastro-oesophageal reflux disease

M. Thomson, A. Fritscher-Ravens, S. Hall, N. Afzal, Paul Ashwood, C. P. Swain

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Aims: To describe paediatric experience, and to assess complications and therapeutic effectiveness of the use of endoluminal gastroplication in children with gastro-oesophageal reflux disease (GORD) refractory to, or dependent on, proton pump inhibitors. Methods: Seventeen (five male) consecutive children/adolescents (median (range) age 12.4 (6.1-15.9) years, median (range) weight 46.0 (16.5-87.5) kg) with GORD either dependent for more than 12 months on proton pump inhibitors or non-responsive to medical treatment underwent endoscopic gastroplication using a flexible endoscopic sewing device (EndoCinch). Three plications were placed in gastric tissue below the lower oesophageal sphincter. Drug dose requirement, pH measurements, daily symptom severity and frequency, and validated reflux (QOLRAD) and general gastrointestinal (GSRS) quality of life scores were compared before and after endoscopic gastroplication. Results: All patients showed post-treatment improvement in symptom severity, frequency, and quality of life scores (p<0.0001). Three patients with recurrent symptomatic GORD had a repeat procedure within six weeks and did well subsequently. At up to 33 months of follow up (median 23), 14/17 patients remained off all antireflux medications, and 14/17 had maintained their symptomatic improvement. All pH parameters improved and had returned to normal values in 14/16 patients post-treatment and in 6/9 after one year of follow-up: in particular the reflux index had decreased from a median of 16.6% (0.9-67%) to 2.5% (0.7-15.7%) (p<0.0001) six weeks and 4.3% (2.2-20.6) (p<0.02) 12 months post-procedure. The only complication observed was gastric bleeding in one patient due to previously undiagnosed coagulopathy, which spontaneously resolved. Conclusions: Endoluminal gastroplication is an effective and safe procedure in children/adolescents with significant GORD refractory to, or dependent on, medical anti-GORD therapy.

Original languageEnglish (US)
Pages (from-to)1745-1750
Number of pages6
JournalGut
Volume53
Issue number12
DOIs
StatePublished - Dec 2004
Externally publishedYes

Fingerprint

Esophageal Diseases
Gastroesophageal Reflux
Proton Pump Inhibitors
Stomach
Quality of Life
Lower Esophageal Sphincter
Therapeutic Uses
Therapeutics
Reference Values
Pediatrics
Hemorrhage
Weights and Measures
Equipment and Supplies
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Thomson, M., Fritscher-Ravens, A., Hall, S., Afzal, N., Ashwood, P., & Swain, C. P. (2004). Endoluminal gastroplication in children with significant gastro-oesophageal reflux disease. Gut, 53(12), 1745-1750. https://doi.org/10.1136/gut.2004.041921

Endoluminal gastroplication in children with significant gastro-oesophageal reflux disease. / Thomson, M.; Fritscher-Ravens, A.; Hall, S.; Afzal, N.; Ashwood, Paul; Swain, C. P.

In: Gut, Vol. 53, No. 12, 12.2004, p. 1745-1750.

Research output: Contribution to journalArticle

Thomson, M, Fritscher-Ravens, A, Hall, S, Afzal, N, Ashwood, P & Swain, CP 2004, 'Endoluminal gastroplication in children with significant gastro-oesophageal reflux disease', Gut, vol. 53, no. 12, pp. 1745-1750. https://doi.org/10.1136/gut.2004.041921
Thomson, M. ; Fritscher-Ravens, A. ; Hall, S. ; Afzal, N. ; Ashwood, Paul ; Swain, C. P. / Endoluminal gastroplication in children with significant gastro-oesophageal reflux disease. In: Gut. 2004 ; Vol. 53, No. 12. pp. 1745-1750.
@article{93cfa3b964974b518c6032bd8de577aa,
title = "Endoluminal gastroplication in children with significant gastro-oesophageal reflux disease",
abstract = "Aims: To describe paediatric experience, and to assess complications and therapeutic effectiveness of the use of endoluminal gastroplication in children with gastro-oesophageal reflux disease (GORD) refractory to, or dependent on, proton pump inhibitors. Methods: Seventeen (five male) consecutive children/adolescents (median (range) age 12.4 (6.1-15.9) years, median (range) weight 46.0 (16.5-87.5) kg) with GORD either dependent for more than 12 months on proton pump inhibitors or non-responsive to medical treatment underwent endoscopic gastroplication using a flexible endoscopic sewing device (EndoCinch). Three plications were placed in gastric tissue below the lower oesophageal sphincter. Drug dose requirement, pH measurements, daily symptom severity and frequency, and validated reflux (QOLRAD) and general gastrointestinal (GSRS) quality of life scores were compared before and after endoscopic gastroplication. Results: All patients showed post-treatment improvement in symptom severity, frequency, and quality of life scores (p<0.0001). Three patients with recurrent symptomatic GORD had a repeat procedure within six weeks and did well subsequently. At up to 33 months of follow up (median 23), 14/17 patients remained off all antireflux medications, and 14/17 had maintained their symptomatic improvement. All pH parameters improved and had returned to normal values in 14/16 patients post-treatment and in 6/9 after one year of follow-up: in particular the reflux index had decreased from a median of 16.6{\%} (0.9-67{\%}) to 2.5{\%} (0.7-15.7{\%}) (p<0.0001) six weeks and 4.3{\%} (2.2-20.6) (p<0.02) 12 months post-procedure. The only complication observed was gastric bleeding in one patient due to previously undiagnosed coagulopathy, which spontaneously resolved. Conclusions: Endoluminal gastroplication is an effective and safe procedure in children/adolescents with significant GORD refractory to, or dependent on, medical anti-GORD therapy.",
author = "M. Thomson and A. Fritscher-Ravens and S. Hall and N. Afzal and Paul Ashwood and Swain, {C. P.}",
year = "2004",
month = "12",
doi = "10.1136/gut.2004.041921",
language = "English (US)",
volume = "53",
pages = "1745--1750",
journal = "Gut",
issn = "0017-5749",
publisher = "BMJ Publishing Group",
number = "12",

}

TY - JOUR

T1 - Endoluminal gastroplication in children with significant gastro-oesophageal reflux disease

AU - Thomson, M.

AU - Fritscher-Ravens, A.

AU - Hall, S.

AU - Afzal, N.

AU - Ashwood, Paul

AU - Swain, C. P.

PY - 2004/12

Y1 - 2004/12

N2 - Aims: To describe paediatric experience, and to assess complications and therapeutic effectiveness of the use of endoluminal gastroplication in children with gastro-oesophageal reflux disease (GORD) refractory to, or dependent on, proton pump inhibitors. Methods: Seventeen (five male) consecutive children/adolescents (median (range) age 12.4 (6.1-15.9) years, median (range) weight 46.0 (16.5-87.5) kg) with GORD either dependent for more than 12 months on proton pump inhibitors or non-responsive to medical treatment underwent endoscopic gastroplication using a flexible endoscopic sewing device (EndoCinch). Three plications were placed in gastric tissue below the lower oesophageal sphincter. Drug dose requirement, pH measurements, daily symptom severity and frequency, and validated reflux (QOLRAD) and general gastrointestinal (GSRS) quality of life scores were compared before and after endoscopic gastroplication. Results: All patients showed post-treatment improvement in symptom severity, frequency, and quality of life scores (p<0.0001). Three patients with recurrent symptomatic GORD had a repeat procedure within six weeks and did well subsequently. At up to 33 months of follow up (median 23), 14/17 patients remained off all antireflux medications, and 14/17 had maintained their symptomatic improvement. All pH parameters improved and had returned to normal values in 14/16 patients post-treatment and in 6/9 after one year of follow-up: in particular the reflux index had decreased from a median of 16.6% (0.9-67%) to 2.5% (0.7-15.7%) (p<0.0001) six weeks and 4.3% (2.2-20.6) (p<0.02) 12 months post-procedure. The only complication observed was gastric bleeding in one patient due to previously undiagnosed coagulopathy, which spontaneously resolved. Conclusions: Endoluminal gastroplication is an effective and safe procedure in children/adolescents with significant GORD refractory to, or dependent on, medical anti-GORD therapy.

AB - Aims: To describe paediatric experience, and to assess complications and therapeutic effectiveness of the use of endoluminal gastroplication in children with gastro-oesophageal reflux disease (GORD) refractory to, or dependent on, proton pump inhibitors. Methods: Seventeen (five male) consecutive children/adolescents (median (range) age 12.4 (6.1-15.9) years, median (range) weight 46.0 (16.5-87.5) kg) with GORD either dependent for more than 12 months on proton pump inhibitors or non-responsive to medical treatment underwent endoscopic gastroplication using a flexible endoscopic sewing device (EndoCinch). Three plications were placed in gastric tissue below the lower oesophageal sphincter. Drug dose requirement, pH measurements, daily symptom severity and frequency, and validated reflux (QOLRAD) and general gastrointestinal (GSRS) quality of life scores were compared before and after endoscopic gastroplication. Results: All patients showed post-treatment improvement in symptom severity, frequency, and quality of life scores (p<0.0001). Three patients with recurrent symptomatic GORD had a repeat procedure within six weeks and did well subsequently. At up to 33 months of follow up (median 23), 14/17 patients remained off all antireflux medications, and 14/17 had maintained their symptomatic improvement. All pH parameters improved and had returned to normal values in 14/16 patients post-treatment and in 6/9 after one year of follow-up: in particular the reflux index had decreased from a median of 16.6% (0.9-67%) to 2.5% (0.7-15.7%) (p<0.0001) six weeks and 4.3% (2.2-20.6) (p<0.02) 12 months post-procedure. The only complication observed was gastric bleeding in one patient due to previously undiagnosed coagulopathy, which spontaneously resolved. Conclusions: Endoluminal gastroplication is an effective and safe procedure in children/adolescents with significant GORD refractory to, or dependent on, medical anti-GORD therapy.

UR - http://www.scopus.com/inward/record.url?scp=9344237720&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=9344237720&partnerID=8YFLogxK

U2 - 10.1136/gut.2004.041921

DO - 10.1136/gut.2004.041921

M3 - Article

C2 - 15542508

AN - SCOPUS:9344237720

VL - 53

SP - 1745

EP - 1750

JO - Gut

JF - Gut

SN - 0017-5749

IS - 12

ER -