Zusammenfassung
Für die Therapie der gastroösophagealen Refluxkrankheit werden derzeit verschiedene neue endoskopische Techniken evaluiert. Diese minimal invasiven endoskopischen Verfahren zielen darauf ab, die Refluxkrankheit durch eine Verbesserung der gastroösophagealen Refluxbarriere zu behandeln. Dies kann auf endoskopischem Wege durch endoluminal platzierbare Nähte, durch Applikation von Radiofrequenzenergie sowie durch Injektion oder Implantation biokompatibler Fremdkörper erreicht werden. Die genannten vielversprechenden Therapiemodalitäten sind allerdings zur Zeit noch nicht für den routinemäßigen Einsatz vorgesehen, sondern müssen erst in laufenden Studien insbesondere hinsichtlich des Langzeiteffektes und möglicher Komplikationen evaluiert werden.
Summary
Various endoscopic techniques are currently evaluated for the treatment of gastro-esophageal reflux disease. These minimally invasive treatment modalities are based on the attempts to improve the gastro-esophageal reflux barrier. By endoscopic means, this can be achieved in various ways: by endoscopically placed endoluminal sutures, application of radiofrequency energy, and finally injection or implantation of biocompatible materials. First results of these endoscopic therapies are promising, however, before they can be considered ready for routine clinical application, ongoing studies have to evaluate long-term effects and potential complications
Literatur
-
1
Armstrong D.
Long-term
safety and efficacy of omeprazole in gastro-oesophageal reflux disease.
Lancet.
2000;
356
610-612
-
2
Bytzer P, Christensen P B, Damkier P, Vinding K, Seersholm N.
Adenocarcinoma
of the esophagus and Barrett’s esophagus: a population-based
study.
Am J Gastroenterol.
1999;
94
86-91
-
3
Deviere J, Pastorelli A, Louis H. et al .
Endoscopic implantation of a biopolymer
in the lower esophageal sphincter for gastroesophageal reflux: a
pilot study.
Gastroenterology in press.
-
4
El-Serag H B, Sonnenberg A.
Opposing time trends
of peptic ulcer and reflux disease.
Gut.
1998;
43
327-333
-
5
Feretis C, Benakis P, Dimopoulos C. et al .
Endoscopic implantation of plexiglas (PMMA)
microspheres for the treatment of GERD.
Gastrointest Endosc.
2001;
53
423-426
-
6
Filipi C J, Lehman G A, Rothstein R I. et al .
Transoral, flexible endoscopic suturing
for treatment of GERD: A multicenter trial.
Gastrointest
Endoscopy.
2001;
53
416-422
-
7
Haber G B, Marcon N E, Kortan P, Kandel G, Cirocco M, Basset N.
A 2 year follow-up of
25 patients undergoing endoluminal gastric plication (ELPG) for
gastroesophageal reflux disease (GERD).
Gastrointest Endoscopy.
2001;
53
AB116
-
8
Klinkenberg-Knol E C, Nelis F, Dent J. et al .
Long-term omeprazole treatment in resistant
gastroesophageal reflux disease: efficacy, safety, and influence
on gastric mucosa.
Gastroenterology.
2000;
118
661-669
-
9
Klinkenberg-Knol E C, Festen H PM, Jansen J BMJ, Lamers C BHW, Nelis F, Snel P.
Long-term
treatment with omeprazole for refractory reflux oesophagitis: efficacy
and safety.
Ann Intern Med.
1994;
121
161-167
-
10
Laine L, Ahnen D, McClain C, Solcia E, Walsh J H.
Review
article: potential gastrointestinal effects of long-term acid suppression
with proton pump inhibitors.
Aliment Pharmacol Ther.
2000;
14
651-668
-
11
Luostarinen M.
Nissen
fundoplication for gastro-esophageal reflux disease: Long-term results.
Annales
Chirurgiae et Gynaecologiae.
1995;
84
115-120
-
12
McDougall N I, Johnston B T, Kee F, Collins J SA, McFarland R J, Love A HG.
Natural
history of reflux oesophagitis: a 10 year follow up of its effect
on patient symptomatology and quality of life.
Gut.
1996;
38
481-486
-
13
Mittal R H, Balaban D H.
The esophagogastric
junction.
N Engl J Med.
1997;
336
924-932
-
14
Mittal R H, Holloway R H, Penagini R, Blackshaw L A, Dent J.
Transient lower
esophageal sphincter relaxation.
Gastroenterology.
1995;
109
601-610
-
15
Rothstein R I, Moodie K.
Depth of endoscopically
placed sutures.
Gastrointest Endoscopy.
2000;
51
AB102
-
16 Stein H J, Feussner H, Siewert J R. Complications
and late consequences of open fundoplications for gastroesophageal
reflux disease. Karger Basel In: Büchler
MW, Frei E, Klaiber C, Krähenbühl L, eds. Gastroesophageal
reflux disease (GERD): Back to surgery? Progress in Surgery, Vol.
23 1997: 128-137
-
17
Swain C P.
Endoscopic
suturing.
Baillière’s Clinical Gastroenterology.
1999;
13
97-108
-
18
Swain C P, Mills T N.
An endoscopic
sewing machine.
Gastrointest Endoscopy.
1986;
32
36-37
-
19
Swain P, Park P -O, Kjellin T, Gong T, Kadirkamanathan S S, Appleyard M.
Endoscopic
gastroplasty for gastroesophageal reflux disease.
Gastrointest
Endoscopy.
2000;
51
AB144
-
20
Triadafilopoulos G, DiBaise J K, Nostrant T T. et al .
Radiofrequency energy delivery
to the gastroesophageal junction for the treatment of GERD.
Gastrointest
Endoscopy.
2001;
53
407-415
-
21
Utley D S, Kim M, Vierra M A, Triadafilopoulos G.
Augmentation
of lower esophageal sphincter pressure and gastric yield pressure
after radiofrequency energy delivery to the gastroesophageal junction:
a porcine model.
Gastrointest Endoscopy.
2000;
52
81-86
-
22
Van Herwaarden M A, Samsom M, Smout A JPM.
Excess gastroesophageal reflux in patients
with hiatus hernia is caused by mechanisms other than transient
LES relaxations.
Gastroenterology.
2000;
119
1439-1446
-
23
Vigneri S, Termini R, Leandro G.
A
comparison of five maintenance therapies for reflux esophagitis.
N
Engl J Med.
1995;
333
1106-1110
-
24
Walker S J, Baxter S T, Morris A I, Sutton R.
Review
article: controversy in the therapy of gastro-oesophageal reflux
disease - long-term proton pump inhibition or laparoscopic
antireflux surgery?.
Aliment Pharmacol Ther.
1997;
11
249-260
Priv.-Doz. Dr. Norbert Weigert
I. Medizinische Klinik, Klinikum St. Elisabeth
Straubing GmbH
St. Elisabeth-Straße 23
94315
Straubing
Phone: 09421/7101571
Fax: 09421/7101574
Email: WeigertN@klinikum-straubing.de
