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We congratulate Schwartz et al for their first reported Endocinch sham control trial (Gut 2007;56:20–8). The results of this trial confirm those of earlier open-label studies1–3 showing that in the short and intermediate term, endoscopic gastroplication improves gastro-oesophageal reflux disease symptoms and quality of life (QOL), and reduces the requirements of acid-inhibitory drugs. In their current study design, they only performed endoscopy/gastroplications in patients who have treatment failure in the active treatment group, and hence the actual proportion of patients who have retention of stitches (or judged to be functional) is unknown in the active treatment group. However, the retention of stitches seems to be a major problem reported with this technique.4,5 In our group, we used only two plications 1 and 2 cm below the Z line along the lesser curve, and used the previous knot …
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