To explore the efficacy of anti reflux mucosal ligation in the treatment of refractory gastroesophageal reflux disease (GERD) for more than 2 years.

A retrospective analysis was conducted on refractory GERD patients who underwent endoscopic anti reflux mucosal ligation treatment at the department of gastroesophageal surgery, Rocket Force Characteristic Medical Center from Dec. 2018 to Dec. 2021, with complete preoperative data. The scores of reflux related symptoms, subjective symptom relief, proton pump inhibitor discontinuation (PPI), postoperative complications, recurrence, and re treatment before and after treatment were evaluated, and the impact of preoperative evaluation results on the satisfaction rate of anti reflux mucosal ligation was compared.

A total of 136 GERD patients were included in this study. There are 67 males and 69 females, with age of [52(38, 60)] years. The median follow-up time was [54 (50, 56)]months, and the scores of 12 GERD related symptoms significantly decreased compared to before treatment (P<0.05); The subjective relief levels of gastrointestinal and extraesophageal symptoms were [70 (40, 95)]% and [70 (30, 95)]%, respectively. The PPI discontinuation rate is 78%, and the satisfaction rate of the therapeutic effect is 68%. In the preoperative evaluation items, only the symptom reflux correlation negative group had a better satisfaction rate of treatment than the positive group (χ²=4.926, P=0.026), and there was no statistically significant difference in the satisfaction rate of treatment between the other items. Mild dysphagia, abdominal distension, diarrhea, and delayed bleeding were observed in 7, 1, 1, and 1 cases respectively after surgery, all of which were relieved after conservative treatment. Three patients with symptomatic recurrence and 10 patients with insufficient efficacy underwent endoscopic treatment again (n=5) or laparoscopic fundus folding surgery (n=8). After intervention with re-anti reflux therapy, 11 patients achieved satisfactory results.

Anti reflux mucosal ligation treatment can alleviate various related symptoms in most selected GERD patients, with a high satisfaction rate of efficacy and PPI discontinuation rate. Preoperative reflux monitoring suggests the presence of reflux hypersensitivity, which may have adverse effects on the therapeutic effect. There is a high satisfaction rate of therapeutic effect and PPI discontinuation rate. There is a high satisfaction rate of therapeutic effect and PPI discontinuation rate. Preoperative reflux monitoring suggests the presence of reflux hypersensitivity, which may have adverse effects on the therapeutic effect. Short- and long-term complications after mucosal ligation are rare and mild, but it should be noted that a few patients may experience delayed bleeding. Endoscopic treatment or anti reflux surgery can be a choice for patients with insufficient efficacy or recurrence.