{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T22:14:20Z","timestamp":1787004860061,"version":"build-2736575974"},"reference-count":41,"publisher":"Georg Thieme Verlag KG","issue":"08","license":[{"start":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T00:00:00Z","timestamp":1679356800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:p>Background\u2002Endoscopic full-thickness plication (EFTP) has shown promising results in gastroesophageal reflux disease (GERD), but its efficacy in GERD after peroral endoscopic myotomy (POEM) is unclear.<\/jats:p>\n                  <jats:p>Methods\u2002In a prospective, randomized trial of post-POEM patients dependent on proton pump inhibitors (PPIs) for documented GERD, patients underwent EFTP (plication to remodel the gastroesophageal flap valve) or an endoscopic sham procedure (positioning of the EFTP device, but no stapling). The primary end point was improvement in acid exposure time (AET) &lt;\u200a6\u200a% (3 months). Secondary end points included improvement in esophagitis (3 months), GERD Questionnaire (GERDQ) score (3 and 6 months), and PPI usage (6 months).<\/jats:p>\n                  <jats:p>Results\u200260 patients were randomized (30 in each group). At 3 months, a significantly higher proportion of patients achieved improvement in AET &lt;\u200a6\u200a% in the EFTP group compared with the sham group (69.0\u200a% [95\u200a%CI 52.1\u201385.8] vs. 10.3\u200a% [95\u200a%CI 0\u201321.4], respectively). EFTP was statistically superior to sham (within-group analysis) in improving esophageal AET, DeMeester Score, and all reflux episodes (P\u200a&lt;\u200a0.001). A nonsignificant improvement in esophagitis was noted in the EFTP group (P\u200a=\u200a0.14). Median GERDQ scores (3 months) were significantly better (P\u200a&lt;\u200a0.001) in the EFTP group, and the same trend continued at 6 months. A higher proportion of patients in the sham group continued to use PPIs (72.4\u200a% [95\u200a%CI 56.1\u201388.7] vs. 27.6\u200a% [95\u200a%CI 11.3\u201343.8]). There were no major adverse events in either group.<\/jats:p>\n                  <jats:p>Conclusion\u2002EFTP improved post-POEM GERD symptoms, 24-hour pH impedance findings with normalization in one-third, and reduced PPI usage at 6 months.<\/jats:p>","DOI":"10.1055\/a-2040-4042","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T19:44:56Z","timestamp":1679427896000},"page":"689-698","source":"Crossref","is-referenced-by-count":21,"title":["Endoscopic full-thickness plication for the treatment of gastroesophageal reflux after peroral endoscopic myotomy: a randomized sham-controlled study"],"prefix":"10.1055","volume":"55","clinical-trial-number":[{"clinical-trial-number":"ctri\/2019\/06\/019819","registry":"10.18810\/clinical-trial-registry-india"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1687-4936","authenticated-orcid":false,"given":"Amit","family":"Maydeo","sequence":"additional","affiliation":[{"name":"Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaurav","family":"Patil","sequence":"additional","affiliation":[{"name":"Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3504-7290","authenticated-orcid":false,"given":"Nagesh","family":"Kamat","sequence":"additional","affiliation":[{"name":"Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5729-8897","authenticated-orcid":false,"given":"Ankit","family":"Dalal","sequence":"additional","affiliation":[{"name":"Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amol","family":"Vadgaonkar","sequence":"additional","affiliation":[{"name":"Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanil","family":"Parekh","sequence":"additional","affiliation":[{"name":"Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajen","family":"Daftary","sequence":"additional","affiliation":[{"name":"Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sehajad","family":"Vora","sequence":"additional","affiliation":[{"name":"Baldota Institute of Digestive Sciences, Gleneagles Global Hospital, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,3,21]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1055\/s-0029-1244080","article-title":"Peroral endoscopic myotomy (POEM) for esophageal achalasia","volume":"42","author":"H Inoue","year":"2010","journal-title":"Endoscopy"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1053\/j.gastro.2013.04.057","article-title":"Peroral endoscopic myotomy for the treatment of achalasia: an international prospective multicenter study","volume":"145","author":"D von Renteln","year":"2013","journal-title":"Gastroenterology"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"2496","DOI":"10.1007\/s00464-015-4507-0","article-title":"A prospective analysis of GERD after POEM on anterior myotomy","volume":"30","author":"H Shiwaku","year":"2016","journal-title":"Surg 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(Enteryx) for treatment of gastroesophageal reflux disease: 6-month results of a prospective, randomized trial","volume":"101","author":"D Domagk","year":"2006","journal-title":"Am J Gastroenterol"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1136\/gutjnl-2020-321811","article-title":"Endoscopic full-thickness plication for the treatment of PPI-dependent GERD: results from a randomised, sham controlled trial","volume":"71","author":"R Kalapala","year":"2022","journal-title":"Gut"},{"key":"ref36","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s10388-019-00689-6","article-title":"Statement for gastroesophageal reflux disease after peroral endoscopic myotomy from an international multicenter experience","volume":"17","author":"H Inoue","year":"2020","journal-title":"Esophagus"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1007\/s00464-015-4321-8","article-title":"Gastroesophageal reflux symptoms do not correlate with 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