© 2005 by BMJ Publishing Group Ltd & British Society of Gastroenterology
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The idea of endoscopic surgery to cure gastro-oesophageal reflux has tremendous appeal and initial data looked very promising, with two thirds of patients off all medication soon after the procedure. However, reflux is a long term condition and as the current study of 70 patients from the University of Lieipzig shows, the initial benefit receded rapidly. By 18 months 80% were considered failures and most were back on medication. Objective measures at 12 months showed no reduction in distal oesophageal acid exposure or lower oesophageal sphincter pressure. Disappointingly, at this time no suture remained in 26% of patients and two out of the three sutures had disappeared in 43%, suggesting that suture loss is an important reason for this poor result. Whether improved suturing techniques will solve this problem remains to be determined.
See p 752
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