Anti-reflux mucosectomy for proton pump inhibitor refractory gastroesophageal reflux disease with hiatal hernia: A case report.

INTRODUCTION: Gastroesophageal reflux disease (GERD) is a prevalent chronic condition primarily treated with proton pump inhibitors (PPIs). However, patients with PPI-refractory GERD and hiatal hernia present significant therapeutic challenges, with conventional treatments often yielding unsatisfactory outcomes. While anti-reflux mucosectomy (ARMS) has emerged as a promising treatment, its efficacy in cases with hiatal hernia remains understudied. The primary objective of this case report is to evaluate the safety and efficacy of ARMS in treating PPI-refractory GERD complicated by hiatal hernia.

CASE PRESENTATION: We report the case of a 77-year-old female patient with PPI-refractory GERD and significant hiatal hernia who underwent ARMS. The procedure successfully reconstructed the barrier at the gastroesophageal junction (GEJ), resulting in marked symptom improvement and enhanced quality of life at 3-month follow-up.

CONCLUSIONS: This case demonstrates that ARMS can be an effective therapeutic option for PPI-refractory GERD patients with hiatal hernia, challenging previous contraindications. Further studies with larger patient cohorts are warranted to validate these findings.