{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:12:43Z","timestamp":1790820763235,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Endoscopic anti\u2010reflux therapies, including anti\u2010reflux mucosectomy (ARMS) and mucosal ablation (ARMA), offer minimally invasive treatment for gastroesophageal reflux disease (GERD) but carry risks of stenosis and delayed bleeding. Closure\u2010focused techniques\u2014anti\u2010reflux mucoplasty (ARM\u2010P) and ARM\u2010P with valve (ARM\u2010P\/V)\u2014were developed to reduce these events, yet no comparative evaluation exists. Therefore, we aimed to clarify whether closure\u2010focused techniques reduce adverse events while preserving efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients undergoing first\u2010time endoscopic anti\u2010reflux therapy at a single\u2010center university hospital between 2012 and 2025 were retrospectively analyzed. Procedures were categorized as conventional (ARMA, ARMS) or closure\u2010focused (ARM\u2010P, ARM\u2010P\/V). A 1:1 propensity score\u2013matched cohort was created using preoperative clinical and endoscopic variables. Primary outcomes were adverse events; secondary outcomes were symptom scores, Hill grade, and discontinuation of acid\u2010suppressive therapy. Treatment effects were estimated using average treatment effect on the treated (ATET).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 251 patients, 94 matched pairs were generated. Adverse events occurred in 5.32% of closure\u2010focused cases versus 25.53% with conventional techniques (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). ATET showed a 40.4% reduction in overall adverse events (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009) and a 30.8% reduction in stenosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.018). At 2\u2009months, acid\u2010suppressive medication was discontinued in 45.74% of closure\u2010focused patients and 35.11% of conventional patients (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.266), with comparable symptomatic and anatomical outcomes, but a longer procedure time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Closure\u2010focused techniques improve safety without compromising clinical or anatomical outcomes and represent a promising refinement of endoscopic anti\u2010reflux therapy; however, these findings should be validated in prospective comparative studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/den.70201","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T14:41:01Z","timestamp":1781534461000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and Safety of Closure\u2010Focused Anti\u2010Reflux Mucoplasty Compared With Conventional\n                    <scp>ARMS<\/scp>\n                    : A Propensity Score\u2013Matched Study (With Video)"],"prefix":"10.1111","volume":"38","author":[{"given":"Kazuki","family":"Yamamoto","sequence":"first","affiliation":[{"name":"Digestive Diseases Center Showa Medical University Koto Toyosu Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5889-7993","authenticated-orcid":false,"given":"Nikko Theodore V.","family":"Raymundo","sequence":"additional","affiliation":[{"name":"Digestive Diseases Center Showa Medical University Koto 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