[Endoscopic cardioplasty--a new therapeutic method in gastroesophageal reflux disease].

BACKGROUND

Gastrooesophageal reflux disease is a common disorder, its most significant pathophysiological mechanism being a dysfunction of the lower oesophageal sphincter.

MATERIALS AND

METHODS

On the basis of our own experience and relevant literature, we present a novel method of treating this disease by means of strengthening the lower oesophageal sphincter by endoscopic suture.

RESULTS AND INTERPRETATION: The commercially available Bard EndoCinch endosuture device was attached to a normal gastroscope and was used to fasten a Prolene thread in a fold of the gastric mucosa approximately one centimetre below the lower oesophageal sphincter. By tying two mucosal folds together, a plication was obtained. Usually, two or three complications were made. The procedure was performed on patients only mildly sedated and typically took 20 to 40 minutes. The method is suitable for patients with moderate or severe reflux disease with hiatal hernias less than 3 cm and may be an alternative to continuous proton pump inhibitor treatment or fundoplication. Contraindications are few, and complications limited. Controlled studies or treatment protocols should be initiated.