Abstract：
OBJECTIVE: Anti-reflux mucosectomy (ARMS) is an emerging and promising endoscopic treatment for gastroesophageal reflux disease (GERD). In the current study we aimed to evaluate the safety and efficacy of ARMS in treating Chinese GERD patients.
METHODS: This was a single-center prospective cohort study. ARMS was performed in GERD patients by an experienced endoscopist. The patients were required to undergo symptom assessment as well as endoscopic examination, high-resolution manometry (HRM), and impedance-pH monitoring before and after ARMS.
RESULTS: Twelve patients were enrolled. Follow-up was completed by all patients at 3 and 6 months, 11 patients at 1 year, and 8 patients at 2 years after ARMS, respectively. Symptom improvement was achieved in 66.7%, 75.0%, 72.7%, and 50.0% of the patients at 3 months, 6 months, 1 year, and 2 years after ARMS, respectively. Postoperative dysphagia was reported by 25.0%, 25.0%, 27.3%, and 25.0% of patients at 3 months, 6 months, 1 year, and 2 years after surgery, none of whom required additional invasive treatment. All patients with preoperative esophagitis healed after ARMS. For impedance-pH monitoring parameters, number of acidic reflux episodes and the proportion of patients with acid exposure time (AET) >4.0% decreased significantly after ARMS.
CONCLUSIONS: ARMS was safe and effective in Chinese GERD patients. The efficacy of ARMS was not short-term and remained evident throughout the 2-year follow-up. Further multicenter studies with larger sample sizes are needed to verify our findings.
METHODS: This was a single-center prospective cohort study. ARMS was performed in GERD patients by an experienced endoscopist. The patients were required to undergo symptom assessment as well as endoscopic examination, high-resolution manometry (HRM), and impedance-pH monitoring before and after ARMS.
RESULTS: Twelve patients were enrolled. Follow-up was completed by all patients at 3 and 6 months, 11 patients at 1 year, and 8 patients at 2 years after ARMS, respectively. Symptom improvement was achieved in 66.7%, 75.0%, 72.7%, and 50.0% of the patients at 3 months, 6 months, 1 year, and 2 years after ARMS, respectively. Postoperative dysphagia was reported by 25.0%, 25.0%, 27.3%, and 25.0% of patients at 3 months, 6 months, 1 year, and 2 years after surgery, none of whom required additional invasive treatment. All patients with preoperative esophagitis healed after ARMS. For impedance-pH monitoring parameters, number of acidic reflux episodes and the proportion of patients with acid exposure time (AET) >4.0% decreased significantly after ARMS.
CONCLUSIONS: ARMS was safe and effective in Chinese GERD patients. The efficacy of ARMS was not short-term and remained evident throughout the 2-year follow-up. Further multicenter studies with larger sample sizes are needed to verify our findings.
摘要：
背景：抗反流粘膜切除术（ARMS）是胃食管反流病（GERD）的一种新兴且有前景的内镜治疗方法。本研究旨在评估ARMS治疗中国GERD患者的安全性和有效性。
方法：这是一项单中心前瞻性队列研究。由经验丰富的内镜医师对入选的GERD患者进行ARMS。这些患者需要接受症状评估和内窥镜检查，ARMS前后的高分辨率测压（HRM）和阻抗pH监测。
结果：共纳入12例患者，所有这些人都在3个月和6个月完成了随访，ARMS后1年11例，2年8例。3个月时症状改善的患者比例，6个月,1年,ARMS后2年为66.7%，75.0%,72.7%,分别为50.0%。手术后吞咽困难的报告为25.0％，25.0%,27.3%,25.0%的患者在3个月时，6个月,手术后1年和2年，没有人需要额外的侵入性治疗。所有术前食管炎患者均在ARMS后愈合。对于阻抗-pH监测参数，ARMS后，酸反流发作次数和酸暴露时间（AET）％>4.0％的患者比例显着降低。
结论：本研究证明ARMS对中国GERD患者是安全有效的。ARMS的疗效不是短期的，在本研究的2年随访期间仍然很明显。仍需要更多样本量的多中心研究来验证我们的发现。本文受版权保护。保留所有权利。
方法：这是一项单中心前瞻性队列研究。由经验丰富的内镜医师对入选的GERD患者进行ARMS。这些患者需要接受症状评估和内窥镜检查，ARMS前后的高分辨率测压（HRM）和阻抗pH监测。
结果：共纳入12例患者，所有这些人都在3个月和6个月完成了随访，ARMS后1年11例，2年8例。3个月时症状改善的患者比例，6个月,1年,ARMS后2年为66.7%，75.0%,72.7%,分别为50.0%。手术后吞咽困难的报告为25.0％，25.0%,27.3%,25.0%的患者在3个月时，6个月,手术后1年和2年，没有人需要额外的侵入性治疗。所有术前食管炎患者均在ARMS后愈合。对于阻抗-pH监测参数，ARMS后，酸反流发作次数和酸暴露时间（AET）％>4.0％的患者比例显着降低。
结论：本研究证明ARMS对中国GERD患者是安全有效的。ARMS的疗效不是短期的，在本研究的2年随访期间仍然很明显。仍需要更多样本量的多中心研究来验证我们的发现。本文受版权保护。保留所有权利。
