Anti-Reflux Mucosectomy: Our Experience & Thoughts For The Future.

PURPOSE OF REVIEW: Gastroesophageal reflux disease is prevalent and has a complex pathophysiology. Though medications are first line, a significant proportion of patients are refractory to this treatment and require anti-reflux surgery (ARS). Though surgery has proven safe and effective, most patients and referring providers are reluctant. Anti-Reflux Mucosectomy (ARMS) provides a less invasive alternative treatment option. This review aims to report our experience with ARMS, discuss other technical variations used, and future directions. Recent Findings In our experience, we note improvement in dysphagia with the modified butterfly-shaped mucosal resection, leading to shorter length of stay, quicker recovery, and equivalent QOL outcomes compared to ARS. We note similar efficacy and safety profiles for anti-reflux mucosal ablation, anti-reflux mucosectomy with cap-assisted mucosal resection, peroral endoscopic cardial constriction, and resection and plication. ARMS and its variations show safety and efficacy as alternative non-invasive treatment options for appropriately selected patients with refractory GERD.