Anti-reflux mucosectomy is associated with better short-term symptoms than double-dose proton pump inhibitor in reflux esophagitis patients

Table 1 Patient demographics and characteristics between the two groups, mean ± SD/n (%)

Characteristic	ARMS (n = 14)	Double-dose PPI (n = 14)	P value
Male	5 (35.7)	5 (35.7)	1.000
Age, year	57.93 ± 12.33	53.79 ± 12.75	0.390
BMI, kg/m2	22.79 ± 1.43	22.56 ± 1.72	0.697
Smoker
Never	10 (71.4)	8 (57.1)	0.430
Former	1 (7.1)	1 (7.1)
Current	3 (21.4)	5 (35.7)
Hypertension	3 (21.4)	4 (28.6)	1.0001
Asthma	0 (0)	1 (7.1)	1.0001
Diabetes	2 (14.3)	2 (14.3)	1.0001
Preop PPI use	14 (100.0)	14 (100.0)	1.0001
Preop pH study	14 (100.0)	14 (100.0)	1.0001
AET	9.09 ± 1.44	8.33 ± 1.65	0.204
Esophagitis	14 (100.0)	14 (100.0)	1.0001
Follow-up, months	6.93 ± 2.50	7.43 ± 2.10	0.571

¹Comparison was conducted with Fisher’s exact test.

PPI: Proton pump inhibitor; ARMS: Anti-reflux mucosectomy; BMI: Body mass index; AET: Acid exposure time; pH: Potential of hydrogen.

Table 2 Patient reported preoperative symptom between the two groups, n (%)

Characteristic	ARMS (n = 14)	Double-dose PPI (n = 14)	P value
Preop symptoms
Belching	5 (35.7)	6 (42.9)	0.699
Reflux	12 (85.7)	11 (78.6)	0.622
Heartburn	9 (64.3)	10 (71.4)	0.686
Regurgitation	8 (57.1)	8 (57.1)	1.000
Dysphagia	4 (28.6)	3 (21.4)	0.663
Cough	2 (14.3)	3 (21.4)	0.622
Laryngitis	8 (57.1)	7 (50.0)	0.705
Dyspnea	1 (7.1)	2 (14.3)	0.541
Epigastric/chest pain	7 (50.0)	6 (42.9)	0.705
Water brash	6 (42.9)	5 (35.7)	0.699
Globus sensation	7 (50.0)	8 (57.1)	0.705
Nausea	2 (14.3)	3 (21.4)	0.622
Emesis	1 (7.1)	1 (7.1)	1.000
Nocturnal symptoms	9 (64.3)	10 (71.4)	0.686

PPI: Proton pump inhibitor; ARMS: Anti-reflux mucosectomy.

Table 3 Patient perioperative outcomes in anti-reflux mucosectomy groups, mean ± SD/n (%)

Characteristic	ARMS (n = 14)
OR time, minutes	31.71 ± 6.94
EBL, mL (median IQR)	5 (2-5)
Length of stay, hours	3.64 ± 0.74
Pain at discharge, VAS (median IQR)	1 (1-2)
3-month complication	0 (0)

ARMS: Anti-reflux mucosectomy; OR: Operation; EBL: Estimated blood loss; VAS: Visual analogue scale; IQR: Interquartile range.

Table 4 Patient pre- and post-operative symptoms outcomes between the two groups, mean ± SD

	ARMS (n = 14)	Double-dose PPI (n = 14)	P value
Preoperative
RSI	29.36 ± 4.80	28.43 ± 6.38	0.667
GERD-HRQL	39.93 ± 3.69	41.57 ± 4.26	0.285
GERDQ	14.21 ± 2.67	13.71 ± 2.55	0.617
RDQ	30.36 ± 5.36	31.71 ± 4.50	0.474
LA grade (C-D)	9	9	1.000
3 weeks postoperative
RSI	17.93 ± 6.94	24.29 ± 4.12	0.007
GERD-HRQL	27.71 ± 7.65	35.21 ± 4.56	0.004
GERDQ	7.64 ± 2.41	11.64 ± 2.92	0.001
RDQ	18.14 ± 7.04	27.07 ± 4.51	< 0.001
3 months postoperative
RSI	16.57 ± 2.47	22.64 ± 2.9	< 0.001
GERD-HRQL	27.57 ± 4.72	38.35 ± 8.02	< 0.001
GERDQ	7.86 ± 2.25	10.57 ± 2.5	0.006
RDQ	18.00 ± 6.97	27.79 ± 3.08	< 0.001
LA grade (C-D)	2	6	0.2091

¹Comparison was conducted with Fisher’s exact test.

PPI: Proton pump inhibitor; ARMS: Anti-reflux mucosectomy; RSI: Reflux symptom index; GERDQ: Gastroesophageal reflux disease questionnaire; GERD-HRQL: Gastroesophageal reflux disease-health-related quality of life; RDQ: Reflux disease questionnaire.