Application status of endoscopic anti-reflux mucosal interventions in the treatment of gastroesophageal reflux disease

Table 9 Advantages and limitations of anti-reflux mucosal intervention in clinical practice (anti-reflux mucosectomy, anti-reflux mucosal ablation, and peroral endoscopic cardial constriction)

Intervention		Advantages	Limitations
ARMS	ARMS-horseshoe	(1) No artificial device implantation required; (2) Short procedure time, hospital stay, and fast recovery than surgery; (3) Does not preclude future laparoscopic surgery; (4) Low bleeding rate; and (5) Available tissue specimens for pathology	Relative higher stenosis rate than ARMA
	ARMS-butterfly	(1) The same as ARMS-horseshoe; and (2) Reduced stenosis rate	Relative higher stenosis rate than ARMA
ARMA	ARMA-horseshoe	(1) No artificial device implantation required; (2) Short procedure time, hospital stay, and fast recovery than surgery; (3) Does not preclude future laparoscopic surgery; (4) Lower stenosis rate than ARMS; (5) Low perforation rate; (6) Adjunctive therapy for post-ARMS; and (7) Can be safely re-administered	(1) Tissue specimens for pathological analysis unavailable; and (2) Relative higher bleeding rate than ARMS
	ARMA-butterfly	(1) The same as ARMA-horseshoe; and (2) Further reduced stenosis rate	(1) Tissue specimens for pathological analysis unavailable; and (2) Higher bleeding rate than ARMS
PECC	PECC-esophagus	(1) Does not preclude future laparoscopic surgery; (2) Short hospital stays, and fast recovery; (3) Easier to conduct than ARMS; (4) Shorter procedure time; (5) Simpler instrumentation required; (6) Lower dysphagia rate than ARMS; and (7) Improves extra-esophageal symptoms	(1) Slight lower therapeutic effective rate; (2) Tissue specimens for pathological analysis unavailable; and (3) Risk of esophageal lesion aggravation
	PECC-stomach	The same as PECC-esophagus	(1) The same as PECC-esophagus; and (2) May exacerbate dysphagia and bloating
	PECC-esophagus & stomach	The same as PECC-esophagus	The same as PECC-stomach

ARMS: Anti-reflux mucosectomy; ARMA: Anti-reflux mucosal ablation; PECC: Peroral endoscopic cardial constriction; NA: Not available.