Jiang WJ, Liu J, Liu YL, Tang MD, Sheng Y, Wang YT. Anti-reflux mucosectomy is associated with better short-term symptoms than double-dose proton pump inhibitor in reflux esophagitis patients. World J Gastrointest Surg 2026; 18(6): 119941 [DOI: 10.4240/wjgs.119941]
Corresponding Author of This Article
Ye-Tao Wang, MD, Chief Physician, Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17 Lujiang Road, Hefei 230001, Anhui Province, China. wangyt96@163.com
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Gastroenterology & Hepatology
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Jiang WJ, Liu J, Liu YL, Tang MD, Sheng Y, Wang YT. Anti-reflux mucosectomy is associated with better short-term symptoms than double-dose proton pump inhibitor in reflux esophagitis patients. World J Gastrointest Surg 2026; 18(6): 119941 [DOI: 10.4240/wjgs.119941]
World J Gastrointest Surg. Jun 27, 2026; 18(6): 119941 Published online Jun 27, 2026. doi: 10.4240/wjgs.119941
Anti-reflux mucosectomy is associated with better short-term symptoms than double-dose proton pump inhibitor in reflux esophagitis patients
Wen-Jun Jiang, Jie Liu, Ying-Ling Liu, Meng-Die Tang, Yuan Sheng, Ye-Tao Wang
Wen-Jun Jiang, Jie Liu, Ying-Ling Liu, Meng-Die Tang, Yuan Sheng, Ye-Tao Wang, Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, Anhui Province, China
Co-first authors: Wen-Jun Jiang and Jie Liu.
Author contributions: Jiang WJ and Liu J drafted the original manuscript; Liu YL conducted and Tang MD conducted the gastroscopy; Sheng Y and Wang YT supervised the study and made critical revisions; Wang YT conceptualized, designed, supervised the study and made critical revisions; Jiang WJ and Liu J contributed equally for the study completion and manuscript writing, they were listed as co-first authors; all authors prepared the final draft and approved the final version.
Supported by the Scientific Research Plan Project of Universities in Anhui Province, No. 2024AH052045.
Institutional review board statement: This study received approval from the Ethics Committee of Anhui Provincial Hospital, No. XJS2022-2-18(NK).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: Data, analytic methods, and study materials are available to other researchers upon request to the corresponding author.
Corresponding author: Ye-Tao Wang, MD, Chief Physician, Department of Gastroenterology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, No. 17 Lujiang Road, Hefei 230001, Anhui Province, China. wangyt96@163.com
Received: February 11, 2026 Revised: March 11, 2026 Accepted: April 3, 2026 Published online: June 27, 2026 Processing time: 131 Days and 7.2 Hours
Abstract
BACKGROUND
Anti-reflux mucosectomy (ARMS) has been introduced as a therapeutic approach for patients with gastroesophageal reflux disease (GERD) refractory to proton pump inhibitor (PPI) therapy.
AIM
To assess the safety, feasibility, and efficacy of ARMS in comparison to double-dose PPI treatment.
METHODS
A retrospective cohort study was conducted at Anhui Provincial Hospital utilizing collected data from March 2023 to January 2026. The study population comprised patients with refractory reflux esophagitis who had previously received single-dose PPI therapy. Participants were categorized into two groups based on the treatment modality: The ARMS group and the double-dose PPI group. Therapeutic efficacy was evaluated by comparing differences in clinical outcomes, including scores from the GERD health-related quality of life (GERD-HRQL) questionnaire, the GERD questionnaire (GERDQ), the reflux disease questionnaire (RDQ), and the reflux symptom index (RSI) between the two groups.
RESULTS
A total of 28 patients with reflux esophagitis were allocated to either the ARMS or double-dose PPI group according to their treatment. Regarding quality of life outcomes, patients undergoing ARMS showed statistically significant improvements in RSI, GERDQ, RDQ, and GERD-HRQL scores at both 3 weeks and 3 months post-treatment compared to those receiving double-dose PPI therapy (all P values < 0.010). The ARMS group demonstrated an operative time of 31.71 ± 6.94 minutes, slight blood loss, short length of hospital stays, and low pain scores at discharge. Additionally, this group exhibited a 0% complication rate within 3 months post-procedure.
CONCLUSION
This pilot study provides preliminary evidence that ARMS may represent a promising endoscopic option for selected patients with refractory reflux esophagitis, though larger prospective studies are needed to confirm its efficacy and safety.
Core Tip: Anti-reflux mucosectomy (ARMS) is an innovative endoscopic technique developed for the management of refractory gastroesophageal reflux disease. The procedure aims to induce submucosal fibrosis following mucosectomy at the esophagogastric junction, offering the advantage of a minimally invasive endoscopic approach. Since its inception, multiple prospective and retrospective studies have been conducted to evaluate the clinical outcomes associated with ARMS. In this context, we present the findings of a retrospective cohort study comparing the efficacy of ARMS to twice-daily proton pump inhibitor (PPI) therapy in a well-defined population of patients exhibiting moderate-to-severe regurgitation despite once-daily PPI treatment.
