S395 Anti-reflux Mucosectomy for Refractory Gastroesophageal Reflux Disease: A Systematic Review and Meta-analysis
Abstract
Introduction: Anti-reflux mucosectomy (ARMS) for refractory gastroesophageal reflux disease (GERD) has been reported to have promising results in recent studies. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of ARMS in refractory GERD. Methods: A comprehensive search of multiple databases (through March 2020) was performed to identify studies that reported outcomes of ARMS for refractory GERD. Outcomes assessed included technical success, clinical response, and adverse events. Clinical response was defined as discontinuation (complete) or reduction (partial) of proton pump inhibitors post-ARMS at follow-up. The pooled rates were calculated using random-effect models and the mixed-effect model was used for subgroup analysis. Results: A total of 307 patients (mean age 46.9 6 8.1 years) were included from 10 studies. The technical success and clinical response rates were 97.7% (95% confidence interval [CI], 94.6 – 99.0, I2 50) and 80.1% (95% CI, 61.6 – 91.0, I2 584.9), respectively. The pooled rate of complete and partial clinical response was 65.3% (95% CI, 51.4 – 77.0, I2 573.1) and 21.5% (95% CI, 14.2 – 31.2, I2 525.5), respectively. The rate of adverse events was 17.2% (95% CI, 13.1 – 22.2, I2 51.9) with most common adverse event being dysphagia/esophageal stricture followed by bleeding with rates of 11.4% (95% CI, 8.2 – 15.7, I2 50) and 5.0% (95% CI, 1.9 – 12.3, I2 5 51.3), respectively. GERD-HRQL (Mean difference {MD}5 14.9, [9.30…
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Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 307 participants or records.
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