{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T12:51:19Z","timestamp":1782305479776,"version":"3.54.5"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background and aims<\/jats:title>\n                    <jats:p>Reusable endoscopes require reprocessing and may carry potential concerns regarding cross-contamination, whereas single-use endoscopes may reduce infection-related risks and simplify workflow. However, evidence remains limited on whether single-use endoscopes can provide comparable performance in therapeutic upper gastrointestinal procedures requiring stable visualization, reliable suction, retroflexion, and accessory compatibility. Endoscopic cardia constriction with ligation (ECCL) is a minimally invasive endoscopic treatment for refractory gastroesophageal reflux disease (GERD). This multicenter randomized controlled trial aims to compare the efficacy, safety, and procedural feasibility of ECCL performed with a single-use endoscope versus a reusable endoscope in patients with refractory GERD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a multicenter, open-label, parallel-group, non-inferiority randomized controlled trial. Ninety-eight adults aged 18\u201380\u202fyears with refractory GERD will be randomized 1:1 to undergo ECCL using either a single-use endoscope or a reusable endoscope. Eligible participants must have typical GERD symptoms for at least 6\u202fmonths, persistent symptoms despite optimized acid-suppressive therapy, and objective evidence supporting GERD diagnosis. ECCL will be performed according to a standardized protocol. Participants will receive standardized post-procedural acid-suppressive therapy for 2\u202fweeks and will be followed at 3 and 6\u202fmonths. The primary efficacy endpoint is clinically significant symptom improvement, defined as a decrease in GERD-Q score of \u22654 points from baseline. Change in GERD-Q score will also be analyzed as a continuous supportive outcome. Secondary endpoints include procedural feasibility, safety outcomes, operational stability, device malfunction\/defect rates, and acid-suppressive medication use after ECCL, including complete discontinuation of PPI\/P-CAB therapy at 3 and 6\u202fmonths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This trial will provide prospective evidence on whether single-use endoscopes can support ECCL with efficacy, safety, and procedural feasibility comparable to reusable endoscopes. By integrating patient-reported outcomes, standardized procedural assessment, device-related events, and post-procedural medication use, this study may inform future clinical application of single-use endoscopes in therapeutic upper gastrointestinal endoscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>ClinicalTrials.gov<\/jats:ext-link>\n                      , identifier NCT07176221.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1832310","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T12:13:31Z","timestamp":1782303211000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of endoscopic cardia constriction ligation with a single-use endoscope versus a reusable endoscope for refractory gastroesophageal reflux disease: protocol for a multicenter randomized controlled trial"],"prefix":"10.3389","volume":"13","author":[{"given":"Run-hua","family":"Li","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Shenzhen Hospital, Southern Medical University","place":["Shenzhen, Guangdong, China"]},{"name":"Shenzhen School of Clinical Medicine, Southern Medical University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-ying","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Daping Hospital, Army Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shenzhen Hospital, Southern Medical University","place":["Shenzhen, Guangdong, China"]},{"name":"Shenzhen School of Clinical Medicine, Southern Medical University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gui-li","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shenzhen Hospital, Southern Medical University","place":["Shenzhen, Guangdong, China"]},{"name":"Shenzhen School of Clinical Medicine, Southern Medical University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shenzhen Hospital, Southern Medical University","place":["Shenzhen, Guangdong, China"]},{"name":"Shenzhen School of Clinical Medicine, Southern Medical University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-bing","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shenzhen Hospital, Southern Medical University","place":["Shenzhen, Guangdong, China"]},{"name":"Shenzhen School of Clinical Medicine, Southern Medical University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Shenzhen Hospital, Southern Medical University","place":["Shenzhen, Guangdong, China"]},{"name":"Shenzhen School of Clinical Medicine, Southern Medical University","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-hua","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, No. 964th Hospital","place":["Changchun, 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