cqvip:Background and Study Aims: Several endoscopic antireflux therapies have been m arketed, but long-term data on their objective and clinical efficacy are sparse . This report presents prospective 1-year follow-up results, including technic al, clinical,and functional success rates, for the first of these treatments to be developed, endoscopic gastroplication (EGP). Patients and Methods: A total of 43 EGP procedures were carried out in 38 patients with gastroesophageal reflux disease (GERD).Two or three EndoCinch gastroplications were constructed at the l evel of the gastric cardia in each patient; five patients were treated twice wit hin 6-12 months. Each endoscopic suture joined two gastric folds to each other as a double fold, known as a “gastroplication", in order to narrow the esophago gastric junction. Postprocedure data after 2 months and after 1 year were compar ed with preoperative data, focusing on symptoms,medication requirements, endosco pic findings, and pH-metry results. Results: In contrast to the findings at 2 m onths (which showed that 72 %of the sutures were present and that there was a r eduction in the percentage of time when the esophageal pH was < 4 from 15.4%to 8.7%), the results 1 year after EGP were considered to indicate failure of the treatment in all 38 patients because none of them still had all of the initially placed gastroplications in situ (90%of gastroplications werelost). The percent age of patients who did not require proton pump inhibitor medication decreased f rom 52%at 2 months to only 20%at 1 year and even more patients had evidence of re-flux esophagitis at 1 year (56%) than had initially demonstrated signs of this (41%). Conclusions: EGP has some short-term beneficial effects on clinica l symptoms and pH-metry. However,mainly due to the loss of the endoscopically p laced sutures,these effects were not maintained at the 1-year follow-up. EGP c an not therefore be recommended for routine clinical use. Better endoscopic meth ods need to be developed, and they should be adequately tested before being mark eted.
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