Rodríguez de Santiago E, Albéniz E, Estremera-Arevalo F, Teruel Sanchez-Vegazo C, Lorenzo-Zúñiga V. Endoscopic anti-reflux therapy for gastroesophageal reflux disease. World J Gastroenterol 2021; 27(39): 6601-6614 [PMID: 34754155 DOI: 10.3748/wjg.v27.i39.6601]
Reader's ID:
02441035
Submitted on:
November 01, 2021, 17:57
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Reader Comments:
The aim of this paper was to give an update review of the endoscopic antireflux treatments with an accurate description of their technical aspects, clinical effectiveness, safety, indications and guidelines, comparing the advantages and disadvantages of each treatment. It seems to me that this purpose has largely been achieved. Unfortunately a conclusive evaluation of these endoscopic treatments in preventing GER was jeopardized both by the exclusive use in the majority of studies of subjective criteria, as the remission of heartburn and GERD HRQL evaluation, and by the general absence, excluding TIF, of objective criteria of evaluation, as the 24-h pH monitoring, the assessment of esophagitis and the manometric measure of the high pressure zone created in the distal esophagus. The impossibility of being able to give an adequate evaluation of the various endoesophageal treatments should be more emphasized by the authors in the comments and conclusions.
There are also some faults and inaccuracies. The state of the art related to the antireflux surgical therapy in the introduction is well done, but the new treatment with the “ magnetic augmentation sphincter device” for the LES was not included.
The Angelchik prosthesis is not an endoscopic, but laparoscopic treatment.
Table I on the comparison of the results and characteristics of the endoscopic treatments for GER should be postponed to the description of each intervention.
The kind of adverse events after TIF should be reported in detail (Huong X et al 2017 ref 52), as it concerns gastrointestinal perforations and bleedings.
The conclusive statement of Richter et al 2018 (ref 53) about the treatment with TIF “we do not recommend it as a long-term alternative to PPI or laparoscopic Nissen fundoplication treatments for GERD”, should be mentioned.
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