A possible endoscopic therapy for large hiatal hernia complicated with refractory gastroesophageal reflux disease
Abstract
A hiatal hernia (HH) is usually associated with gastro-esophageal re fl ux disease (GERD). An HH can increase the incidence of GERD. [1] The coexistence of these diseases increases the dif fi culty of treatment and can be challenging for endoscopic treatment. Therapeutic methods for small HHs ( (cid:1) 2 cm) combined with refractory GERD have recently been emerging. However, there are still knowledge gaps in the endoscopic treatment of large HHs ( ≥ 3 cm) combined with refractory GERD. We developed a new endoscopic method called hiatal hernia-endoscopic submucosal dissection (HH-ESD) and performed the present study to clarify the ef fi cacy and safety of HH-ESD. This clinical trial was approved by the Ethics Committee of the Af fi liated People ’ s Hospital of Inner Mongolia Medical University (No. KY201801) and registered at the China Clinical Trial Registry (clinical trial number: ChiCTR2000034032). The inclusion criteria were (1) an age of 18 to 75 years; (2) symptoms of acid regurgitation and heartburn that were not signi fi cantly relieved or that relapsed after > 2 months of daily proton pump inhibitor (PPI) therapy; (3) diagnosis of a sliding HH ( ≥ 3 cm) by gastroscopy, radiography, and esophageal
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