Network meta-analysis of the efficacy of endoscopic cardia peripheral tissue scar formation (ECSF) in the treatment of gastroesophageal reflux disease
Endoscopic antireflux therapy is widely used in clinical practice. Peroral endoscopic cardial constriction (PECC), antireflux mucosal intervention (ARMI), and radiofrequency ablation (RF) possess analogous antireflux mechanisms. This comprehensive systematic review and meta-analysis aimed to evaluat...
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| description | Endoscopic antireflux therapy is widely used in clinical practice. Peroral endoscopic cardial constriction (PECC), antireflux mucosal intervention (ARMI), and radiofrequency ablation (RF) possess analogous antireflux mechanisms. This comprehensive systematic review and meta-analysis aimed to evaluate and compare the safety and effectiveness of antireflux therapy during endoscopic cardia peripheral tissue scar formation (ECSF) procedures. We comprehensively searched the Web of Science, PubMed, Embase, China National Knowledge Infrastructure, and Wan-Fang databases for articles published from January 1990 to January 2024. Network meta-analysis (NMA) was used to assess the outcomes, with outcome metrics including the Gastroesophageal Reflux Questionnaire (GERD-Q) score, proton pump inhibitor discontinuation rate, pH |
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Peroral endoscopic cardial constriction (PECC), antireflux mucosal intervention (ARMI), and radiofrequency ablation (RF) possess analogous antireflux mechanisms. This comprehensive systematic review and meta-analysis aimed to evaluate and compare the safety and effectiveness of antireflux therapy during endoscopic cardia peripheral tissue scar formation (ECSF) procedures. We comprehensively searched the Web of Science, PubMed, Embase, China National Knowledge Infrastructure, and Wan-Fang databases for articles published from January 1990 to January 2024. Network meta-analysis (NMA) was used to assess the outcomes, with outcome metrics including the Gastroesophageal Reflux Questionnaire (GERD-Q) score, proton pump inhibitor discontinuation rate, pH <4.2 percent acid reflux time (AET), lower esophageal pressure (LES pressure), DeMeester score, adverse events, and patient satisfaction. Twenty studies involving 1219 patients were included. PECC was significantly superior to RF in lowering the patients' postoperative GERD-Q scores(MD = -2.34, 95% confidence interval (CI): [-3.02, -1.66]), augmentation of LES pressures(MD = 3.22, 95% CI: [1.21, 5.23]), and having a lower incidence of serious adverse events. ARMI was preferable to PECC (MD = -2.87, 95% CI [-4.23, -1.51])and RF (MD = -1.12, 95% CI [-1.79, -0.54]) in reducing the AET percentage, but was not as effective as PECC in lowering GERD-Q scores(MD = -1.50, 95% CI [-2.47, -0.53]). The incidence of adverse effects was less than 10% for all interventions, with most of them mildly self-resolving. Each ECSF procedure resulted in a favorable outcome in patients with GERD. Considering the safety and efficacy of treatment, PECC was the most favorable choice among ECSF procedures.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0311208</identifier><identifier>PMID: 39739987</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Ablation ; Ablation (Surgery) ; Adverse events ; Cardia - pathology ; Cardia - surgery ; Care and treatment ; China ; Cicatrix - pathology ; Cohort analysis ; Diseases ; Dysphagia ; Effectiveness ; Endoscopy ; Esophagus ; Evidence-based medicine ; Gastroesophageal reflux ; Gastroesophageal Reflux - pathology ; Gastroesophageal Reflux - surgery ; Gastroesophageal Reflux - therapy ; Health services ; Humans ; Intervention ; Medical research ; Medicine and Health Sciences ; Medicine, Experimental ; Meta-analysis ; Network Meta-Analysis ; Patient satisfaction ; Patients ; People and Places ; Physical Sciences ; Proton pump inhibitors ; Radio frequency ; Research and Analysis Methods ; Statistical analysis ; Surgery ; Treatment Outcome</subject><ispartof>PloS one, 2024-12, Vol.19 (12), p.e0311208</ispartof><rights>Copyright: © 2024 Shi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Shi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Shi et al 2024 Shi et al</rights><rights>2024 Shi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3888-46b49c37fcea24e830f66532e4746dd9d33143033fb1f3c37a204d345118ba863</cites><orcidid>0000-0003-3618-1723</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687871/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687871/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39739987$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Gou, Jiangtao</contributor><creatorcontrib>Shi, Chaoyi</creatorcontrib><creatorcontrib>Zhou, Shunhai</creatorcontrib><creatorcontrib>Chen, Xuanran</creatorcontrib><creatorcontrib>Shen, Diyun</creatorcontrib><creatorcontrib>Wang, Tianyue</creatorcontrib><creatorcontrib>ZhuoMa, GeSang</creatorcontrib><creatorcontrib>Feng, Mingzhi</creatorcontrib><creatorcontrib>Sun, Yan</creatorcontrib><creatorcontrib>Zhang, Jun</creatorcontrib><title>Network meta-analysis of the efficacy of endoscopic cardia peripheral tissue scar formation (ECSF) in the treatment of gastroesophageal reflux disease</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Endoscopic antireflux therapy is widely used in clinical practice. Peroral endoscopic cardial constriction (PECC), antireflux mucosal intervention (ARMI), and radiofrequency ablation (RF) possess analogous antireflux mechanisms. This comprehensive systematic review and meta-analysis aimed to evaluate and compare the safety and effectiveness of antireflux therapy during endoscopic cardia peripheral tissue scar formation (ECSF) procedures. We comprehensively searched the Web of Science, PubMed, Embase, China National Knowledge Infrastructure, and Wan-Fang databases for articles published from January 1990 to January 2024. Network meta-analysis (NMA) was used to assess the outcomes, with outcome metrics including the Gastroesophageal Reflux Questionnaire (GERD-Q) score, proton pump inhibitor discontinuation rate, pH <4.2 percent acid reflux time (AET), lower esophageal pressure (LES pressure), DeMeester score, adverse events, and patient satisfaction. Twenty studies involving 1219 patients were included. PECC was significantly superior to RF in lowering the patients' postoperative GERD-Q scores(MD = -2.34, 95% confidence interval (CI): [-3.02, -1.66]), augmentation of LES pressures(MD = 3.22, 95% CI: [1.21, 5.23]), and having a lower incidence of serious adverse events. ARMI was preferable to PECC (MD = -2.87, 95% CI [-4.23, -1.51])and RF (MD = -1.12, 95% CI [-1.79, -0.54]) in reducing the AET percentage, but was not as effective as PECC in lowering GERD-Q scores(MD = -1.50, 95% CI [-2.47, -0.53]). The incidence of adverse effects was less than 10% for all interventions, with most of them mildly self-resolving. Each ECSF procedure resulted in a favorable outcome in patients with GERD. Considering the safety and efficacy of treatment, PECC was the most favorable choice among ECSF procedures.</description><subject>Ablation</subject><subject>Ablation (Surgery)</subject><subject>Adverse events</subject><subject>Cardia - pathology</subject><subject>Cardia - surgery</subject><subject>Care and treatment</subject><subject>China</subject><subject>Cicatrix - pathology</subject><subject>Cohort analysis</subject><subject>Diseases</subject><subject>Dysphagia</subject><subject>Effectiveness</subject><subject>Endoscopy</subject><subject>Esophagus</subject><subject>Evidence-based medicine</subject><subject>Gastroesophageal reflux</subject><subject>Gastroesophageal Reflux - pathology</subject><subject>Gastroesophageal Reflux - surgery</subject><subject>Gastroesophageal Reflux - therapy</subject><subject>Health services</subject><subject>Humans</subject><subject>Intervention</subject><subject>Medical research</subject><subject>Medicine and Health Sciences</subject><subject>Medicine, Experimental</subject><subject>Meta-analysis</subject><subject>Network Meta-Analysis</subject><subject>Patient satisfaction</subject><subject>Patients</subject><subject>People and Places</subject><subject>Physical Sciences</subject><subject>Proton pump inhibitors</subject><subject>Radio frequency</subject><subject>Research and Analysis Methods</subject><subject>Statistical analysis</subject><subject>Surgery</subject><subject>Treatment 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meta-analysis of the efficacy of endoscopic cardia peripheral tissue scar formation (ECSF) in the treatment of gastroesophageal reflux disease</title><author>Shi, Chaoyi ; Zhou, Shunhai ; Chen, Xuanran ; Shen, Diyun ; Wang, Tianyue ; ZhuoMa, GeSang ; Feng, Mingzhi ; Sun, Yan ; Zhang, Jun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3888-46b49c37fcea24e830f66532e4746dd9d33143033fb1f3c37a204d345118ba863</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Ablation</topic><topic>Ablation (Surgery)</topic><topic>Adverse events</topic><topic>Cardia - pathology</topic><topic>Cardia - surgery</topic><topic>Care and treatment</topic><topic>China</topic><topic>Cicatrix - pathology</topic><topic>Cohort analysis</topic><topic>Diseases</topic><topic>Dysphagia</topic><topic>Effectiveness</topic><topic>Endoscopy</topic><topic>Esophagus</topic><topic>Evidence-based medicine</topic><topic>Gastroesophageal reflux</topic><topic>Gastroesophageal Reflux - pathology</topic><topic>Gastroesophageal Reflux - surgery</topic><topic>Gastroesophageal Reflux - therapy</topic><topic>Health services</topic><topic>Humans</topic><topic>Intervention</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Medicine, Experimental</topic><topic>Meta-analysis</topic><topic>Network Meta-Analysis</topic><topic>Patient satisfaction</topic><topic>Patients</topic><topic>People and Places</topic><topic>Physical Sciences</topic><topic>Proton pump inhibitors</topic><topic>Radio frequency</topic><topic>Research and Analysis Methods</topic><topic>Statistical analysis</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shi, Chaoyi</creatorcontrib><creatorcontrib>Zhou, Shunhai</creatorcontrib><creatorcontrib>Chen, 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Shunhai</au><au>Chen, Xuanran</au><au>Shen, Diyun</au><au>Wang, Tianyue</au><au>ZhuoMa, GeSang</au><au>Feng, Mingzhi</au><au>Sun, Yan</au><au>Zhang, Jun</au><au>Gou, Jiangtao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Network meta-analysis of the efficacy of endoscopic cardia peripheral tissue scar formation (ECSF) in the treatment of gastroesophageal reflux disease</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2024-12-31</date><risdate>2024</risdate><volume>19</volume><issue>12</issue><spage>e0311208</spage><pages>e0311208-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Endoscopic antireflux therapy is widely used in clinical practice. Peroral endoscopic cardial constriction (PECC), antireflux mucosal intervention (ARMI), and radiofrequency ablation (RF) possess analogous antireflux mechanisms. This comprehensive systematic review and meta-analysis aimed to evaluate and compare the safety and effectiveness of antireflux therapy during endoscopic cardia peripheral tissue scar formation (ECSF) procedures. We comprehensively searched the Web of Science, PubMed, Embase, China National Knowledge Infrastructure, and Wan-Fang databases for articles published from January 1990 to January 2024. Network meta-analysis (NMA) was used to assess the outcomes, with outcome metrics including the Gastroesophageal Reflux Questionnaire (GERD-Q) score, proton pump inhibitor discontinuation rate, pH <4.2 percent acid reflux time (AET), lower esophageal pressure (LES pressure), DeMeester score, adverse events, and patient satisfaction. Twenty studies involving 1219 patients were included. PECC was significantly superior to RF in lowering the patients' postoperative GERD-Q scores(MD = -2.34, 95% confidence interval (CI): [-3.02, -1.66]), augmentation of LES pressures(MD = 3.22, 95% CI: [1.21, 5.23]), and having a lower incidence of serious adverse events. ARMI was preferable to PECC (MD = -2.87, 95% CI [-4.23, -1.51])and RF (MD = -1.12, 95% CI [-1.79, -0.54]) in reducing the AET percentage, but was not as effective as PECC in lowering GERD-Q scores(MD = -1.50, 95% CI [-2.47, -0.53]). The incidence of adverse effects was less than 10% for all interventions, with most of them mildly self-resolving. Each ECSF procedure resulted in a favorable outcome in patients with GERD. Considering the safety and efficacy of treatment, PECC was the most favorable choice among ECSF procedures.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>39739987</pmid><doi>10.1371/journal.pone.0311208</doi><orcidid>https://orcid.org/0000-0003-3618-1723</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Ablation Ablation (Surgery) Adverse events Cardia - pathology Cardia - surgery Care and treatment China Cicatrix - pathology Cohort analysis Diseases Dysphagia Effectiveness Endoscopy Esophagus Evidence-based medicine Gastroesophageal reflux Gastroesophageal Reflux - pathology Gastroesophageal Reflux - surgery Gastroesophageal Reflux - therapy Health services Humans Intervention Medical research Medicine and Health Sciences Medicine, Experimental Meta-analysis Network Meta-Analysis Patient satisfaction Patients People and Places Physical Sciences Proton pump inhibitors Radio frequency Research and Analysis Methods Statistical analysis Surgery Treatment Outcome |
| title | Network meta-analysis of the efficacy of endoscopic cardia peripheral tissue scar formation (ECSF) in the treatment of gastroesophageal reflux disease |
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