Han Z, Jiang HB, Wang FK, Wang ZY, Pang HF, Wang YY, Wei M. Endoscopic anti-reflux mucosal resection for patients with gastroesophageal reflux disease: Clinical efficacy and impact on gut microbiota. World J Gastrointest Surg 2025; 17(6): 103336 [DOI: 10.4240/wjgs.v17.i6.103336]
Corresponding Author of This Article
Yuan-Yuan Wang, MD, Doctor, Department of Gastrointestinal Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Yuhua District, Shijiazhuang 050023, Hebei Province, China. 13933888224@163.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Zhe Han, Hai-Bo Jiang, Fan-Ke Wang, Zhong-Yu Wang, Hong-Fei Pang, Ming Wei, Second Department of Gastrointestinal Disease Diagnosis and Treatment, The First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei Province, China
Yuan-Yuan Wang, Department of Gastrointestinal Surgery, The First Hospital of Hebei Medical University, Shijiazhuang 050023, Hebei Province, China
Co-first authors: Zhe Han and Hai-Bo Jiang.
Co-corresponding authors: Yuan-Yuan Wang and Ming Wei.
Author contributions: Han Z, Jiang HB, Wang FK, Wang ZY, Pang HF, Wang YY, and Wei M contributed equally to this work; Wang FK, Wang ZY, and Pang HF designed the research study, performed the primary literature screening and data extraction; Han Z and Jiang HB analyzed the data and wrote the manuscript; Wang YY and Wei M were responsible for revising the manuscript for important intellectual content; all authors read and approved the final version.
Institutional review board statement: The study was reviewed and approved by the First Hospital of Hebei Medical University (No. 2023-S00706).
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author. Participants gave informed consent for data sharing.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Yuan Wang, MD, Doctor, Department of Gastrointestinal Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Yuhua District, Shijiazhuang 050023, Hebei Province, China. 13933888224@163.com
Received: February 12, 2025 Revised: March 17, 2025 Accepted: April 11, 2025 Published online: June 27, 2025 Processing time: 107 Days and 3.2 Hours
Abstract
BACKGROUND
In recent years, endoscopic anti-reflux mucosal resection (ARMS) has demonstrated benefits, including good efficacy, ease of operation, low cost, and fewer complications; however, it is still in the exploratory stage.
AIM
To evaluate the clinical efficacy of ARMS in patients with gastroesophageal reflux disease (GERD) and its effects on the gut microbiota.
METHODS
This single-center, retrospective, self-controlled study included 80 patients with GERD. All patients underwent endoscopic ARMS and were followed for at least 3 months after surgery. The primary outcome measures were changes in the gut microbiota before and after treatment and clinical efficacy.
RESULTS
After surgery, the counts of Escherichia coli and Staphylococcus aureus were significantly lower than those before surgery (P < 0.05), whereas the counts of Bifidobacterium and Lactobacillus were significantly higher than those before surgery (P < 0.05). Symptoms, such as reflux and heartburn, were markedly relieved postoperatively. The average Gerd Q score prior to surgery was 11.32 ± 1.26 points, which decreased to 5.89 ± 0.52 points 3 months after surgery. All patients used proton pump inhibitors before surgery, and the proportion of patients using proton pump inhibitors declined significantly postoperatively. Sixteen patients (20.0%) experienced surgery-related adverse reactions within 2 weeks to 1 month post-surgery. The incidence rates of postoperative esophageal stricture and delayed bleeding were 15.0% and 5.0%, respectively.
CONCLUSION
Endoscopic ARMS can effectively alleviate reflux symptoms, maintain gut microbiota balance, and improve gastrointestinal function in patients with GERD.
Core Tip: In recent years, endoscopic anti-reflux mucosal resection (ARMS) has demonstrated benefits, including good efficacy, ease of operation, low cost, and fewer complications; however, it is still in the exploratory stage. This study evaluated the clinical efficacy of ARMS in patients with gastroesophageal reflux disease (GERD) and its effects on gut microbiota. It was found that endoscopic ARMS can effectively alleviate reflux symptoms, maintain gut microbiota balance, and improve gastrointestinal function in patients with GERD.
