Anti-reflux mucosectomy with banding (ARMS-B) for GORD: a pilot study

Objective Gastro-oesophageal reflux disease (GORD) is common and frequently challenging to treat. Anti-reflux mucosectomy (ARMS) techniques show promise but can be technically demanding. ARMS with banding (ARMS-B) is a variant of the technique and uses a standard banding kit to apply bands in a crescentic fashion to the cardia to induce scarring. We evaluated the safety and efficacy of this novel procedure. Design/methods This was a single-centre, prospective cohort study. Patients with proton pump inhibitor (PPI)-refractory, symptomatic GORD confirmed on ambulatory pH monitoring were eligible. Repeat pH monitoring was performed at 3 months. Primary outcomes included change in acid exposure time (AET), gastro-oesophageal reflux disease health-related quality of life (GORD-HQRL) scores and adverse events. Secondary outcomes included change in PPI usage and procedure time. Results 13 patients were included in the final analysis (69.2% women; mean age 51.3 years, mean body mass index 22.9). Median follow-up duration was 6.3 months (3.5–24). Post treatment, AET normalised in 60% (9.9% vs 5.2%, 95% CI (1.01 to 8.3), p=0.02) and GORD-HQRL scores normalised in 54.5% (34.7 vs 22.3, 95% CI (1.7 to 23), p=0.03). 46.2% of patients ceased or reduced the dose of their PPI at 3 months. No complications were reported in early or late follow-up. Conclusion This pilot study demonstrates that ARMS-B is both safe and effective for the treatment of GORD. The procedure led to significant reductions in AET, GORD-HRQL, symptom control and PPI usage. Further studies with larger cohorts and longer follow-up periods are warranted to confirm these findings.