The Effects Of Endoscopic Ttreatment Of Cardiac Lesions On Gastroesophageal Reflux Disease

Objective: To explore the effects of endoscopic mucosal resection(EMR)or end oscopic submucosal dissection(ESD)treatment of cardia lesions on Gastroesopha geal reflux disease(GERD).Methods: From August 2017 to May 2020 in our hospital,patients who were endoscopically diagnosed with GERD and cardia lesions(cardia polyps,cardia precancerous lesions and early cardia cancer)and received EMR or ESD treatment were selected,and their clinical data were retrospectively analyzed,a total of 62 patients were included,including 39 males and 23 females,aged 39-79(61.4±10.7)years;18 cases of cardia polyps,43 cases of cardia precancerous lesions,and 1 case of early cardia adenocarcinoma.Postoperative follow-up and gastroscopy were performed at 3 and 6months after surgery to investigate the effect of EMR / ESD on GERD by observing the GERD questionnaire(GERD-Q)scores before and after surgery,GERD health-related quality of life(GERD-HRQL)scale scores and RE classification(Los Angeles classification,LA)scores.Results:(1)GERD-HRQL and GERD-Q scores of the patients: after 3 months(3.842 ±1.804 points and 1.204 ± 0.453)and postoperative 6 months(4.052 ± 1.937 points and1.315 ± 0.873)compared with preoperative(19.033 ± 6.721 points and 11.053 + 2.025)were significantly lower,the difference had statistical significance(P < 0.001).(2)The proportion of grade B and grade C patients in the RE grading of postoperative patients was significantly decreased,and the proportion of normal patients was significantly increased.Compared with preoperatively,the difference was statistically significant(P<0.001).(3)The basic cure rates of GERD at three and six months after surgery are as high as 83.87%(52/62)and 85.48%(53/62),respectively.Conclusion: After EMR/ESD treatment for cardia lesions,a fibrous scar was generated postoperatively to reconstruct the anti reflux barrier,which can effectively control patients’ reflux symptoms,improve patients’ quality of life,promote esophageal mucosal healing,and to some extent relieve or even cure gastroesophageal reflux disease.