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From Surgical Endoscopy
During the ARMS procedure, the endoscopic surgeon cuts away some of the Gastric mucosa below the Lower Oesophageal Sphincter. The scar tissue helps reform the junction.
A similar technique is Anti-reflux mucosal ablation (ARMA) using ablation instead of mucosectomy.
From Peptest
Anti-reflux mucosectomy (ARMS) is an endoscopic procedure that has been hailed as a novel treatment for people with reflux disease who have not responded to PPIs.
ARMS rebuilds the mucosal flap valve at gastric cardia (the area where the contents of the oesophagus empties into the stomach).
The ARMS procedure is based on the principle that after mucosal resection, the mucosal healing results in scar formation. This in turn results in shrinkage of the gastric cardia flap valve, leading to a reduction in reflux episodes by suppressing gastric backflow.
In early studies, researchers found that patients with PPI-refractory gastroesophageal reflux disease (GERD/ GORD) without a sliding hiatal hernia seem to be the best candidates for ARMS treatment.
ARMS and ARMA
ARMS and ARMA
From CLINICAL OUTCOMES OF ENDOSCOPIC ANTI-REFLUX TREATMENT METHODS; ANTI-REFLUX MUCOSECTOMY (ARMS) AND ANTI-REFLUX MUCOSAL ABLATION (ARMA) (Gastrointestinal Endoscopy 2020): "In 2014, we reported Anti-reflux mucosectomy (ARMS) which utilizes ESD or EMR-C to rebuild the flap valve at the gastric cardia by scarring of the artificial ulcer. In 2018, we developed Anti-reflux mucosal ablation (ARMA) where we apply ablation instead of mucosectomy as an alternative therapy for PPI-refractory GERD."
Conclusion:
Both ARMS and ARMA were effective anti-reflux therapy methods for PPI-refractory GERD which improved GERD related symptoms and objective acid reflux parameters. ARMA may be advantageous on its easiness and simplicity regarding operative time
A paper from Surgical Endoscopy in 2024, compared ARMS with Stretta concluding, "The ARMS group had a greater GERDQ score improvement than the SRF group but had symptom relief and PPI discontinuation rates similar to those of the SRF group.
Page updated 15 July 2024
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