Endoscopy 2023; 55(S 02): S328
DOI: 10.1055/s-0043-1765931
Abstracts | ESGE Days 2023
ePoster

Endoscopic full-thickness plication for treatment of PPI-dependent Gastroesophageal Reflux Disease: a case of severe adverse event

G. Valerii
1   Gastroenterologia ed Endoscopia – Ospedale Teramo, Teramo, Italy
,
S. Longo
2   University of L'Aquila, L'Aquila, Italy
,
N. Rubino
3   Ospedali riuniti San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
,
C. Cellini
1   Gastroenterologia ed Endoscopia – Ospedale Teramo, Teramo, Italy
,
C. Barbera
1   Gastroenterologia ed Endoscopia – Ospedale Teramo, Teramo, Italy
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    Aims Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal disorders, with a global prevalence of approximately 20% of adults in Western countries. Treatment options for patients with chronic GERD include long term therapy with Proton Pump Inhibitors (PPIs), laparoscopic fundoplication or endoscopic anti-reflux procedures. Endoscopic full-thickness plication with GERDx (G-SURG, Germany) device has been proven to be safe and effective in improving quality of life in PPI-dependent patients who refuse surgery or long-term medications are not an option. We showed a case of adverse event(SAE) and management related to the device after GERDx.

    Methods We performed a GERDx on 64-years-old male patient affected by GERD on PPI-dependent patients who refuse surgery. The patient has a history of reflux esophagitis (Los Angeles grade C) with classic GERD symptoms (heartburn and regurgitation) on long-terms PPI

    Results We performed GERDx in endoscopic room and lasted 30 minutes under anesthesiological assistance without intraoperative complications. The patient complained of intractable postoperative pain at 48 hours. The chest and abdomen CT is performed and showed pleural empyema at 72 hours. A diagnostic laparoscopy were performed and revealed suture passing through the left crus of diaphragm. The suture had to be removed and a Dor fundoplication was performed followed by video-assisted thoracoscopic surgery (VATS). The patient is discharged after 30 days in good general condition [1] [2].

    Conclusions GERDx is an effective and low invasive technique to treat GERD. Serious adverse events require the availability of surgeons with experience in thoracoscopic and abdominal surgery.


     

    Conflicts of interest

    Authors do not have any conflict of interest to disclose.


    Publication History

    Article published online:
    14 April 2023

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