Original Contribution
The American Journal of Gastroenterology (2006) 101, 422–430; doi:10.1111/j.1572-0241.2006.00533.x
Endoluminal Gastroplasty (EndoCinch™) versus Endoscopic Polymer Implantation (Enteryx™) for Treatment of Gastroesophageal Reflux Disease: 6-Month Results of a Prospective, Randomized Trial
Dirk Domagk MD1, Josef Menzel MD1, Matthias Seidel MD1, Hansjörg Ullerich MD1, Thorsten Pohle MD1, Achim Heinecke PhD2, Wolfram Domschke MD, FACG, FRCP (Lond)1 and Torsten Kucharzik MD1
- 1Departments of Medicine B and Medical Informatics and Biomathematics, Muenster/Germany
- 2University of Muenster, Muenster/Germany
Correspondence: Dirk Domagk, MD, Department of Medicine B, University of Muenster Albert-Schweitzer-Str. 33 D-48129 Muenster/Germany
Received 27 June 2005; Revised 0000; Accepted 17 October 2005.
Abstract
OBJECTIVES:
The aim of this study was to compare and determine the efficiency and safety of two newly introduced endoscopic antireflux procedures in the treatment of gastroesophageal reflux disease (GERD).
METHODS:
In a prospective, randomized trial, endoluminal gastroplasty (EndoCinch™) was compared with polymer injection (Enteryx™) employing 51 consecutive patients dependent on proton pump inhibitor therapy. Follow-up evaluation included drug consumption, symptoms, quality-of-life scoring, endoscopy, pH monitoring, manometry, and documentation of adverse events.
RESULTS:
Twenty-six patients were assigned to EndoCinch™ treatment, 23 patients received Enteryx™ implantation, and two patients dropped out before applying endoscopic therapy. At 6 months, proton pump inhibitor therapy could be stopped or dosage was reduced by 
50% in 20 of 26 (77%) EndoCinch-treated patients and in 20 of 23 patients treated by Enteryx™ (87%, p= 0.365), which differed significantly in both groups compared to the pre-interventional status (p < 0.0001). Esophageal acid reflux (pH < 4) decreased from 14.5% to 9.6% in EndoCinch-treated patients (p= 0.071) and from 15.5% to 13.9% in patients treated by Enteryx™ (p= 0.930). Heartburn symptom score, modified DeMeester score, gastrointestinal life quality index, and SF-36 physical health survey score improved significantly in both groups postinterventionally (p < 0.0001). Approximately 25% of the patients in both groups required retreatment in an attempt to achieve symptom control.
CONCLUSIONS:
This is the first prospective, randomized study directly comparing two endoscopic anti-GERD techniques. EndoCinch™ and Enteryx™ seem to be equally successful in the treatment of GERD significantly reducing the proton pump inhibitor dosages, and also by improving symptoms of patients. Both endoluminal antireflux procedures may be promising therapeutic options; long-term evaluation will have to show if the positive initial results can be maintained.
