{
  "abstract": "Background Gastroesophageal reflux disease (GERD) is a chronic condition affecting up to 20% of adults in Western countries and an increasing proportion in Asia. While proton pump inhibitors (PPIs) remain first-line therapy, long-term use is associated with incomplete symptom control, medication dependence, and potential adverse effects. Minimally invasive endoscopic anti-reflux procedures targeting the gastric cardia have emerged as promising alternatives to pharmacologic or surgical interventions.Methods This single-center, retrospective cohort aimed to compare the short-term anti-reflux efficacy and safety of radiofrequency ablation (RFA) versus band mucosal ligation (BML) of the cardiac mucosa in patients with PPI-dependent moderate-to-severe GERD. Sixty adult patients with confirmed GERD (GERD-Q ≥8, abnormal 24-hour pH monitoring) were randomly assigned (1:1) to undergo either RFA or BML. Primary endpoints at 12 weeks included change in GERD-Q score, PPI discontinuation rate, and reduction in esophageal acid exposure (DeMeester score). Secondary outcomes included procedure time, adverse events, and patient-reported satisfaction.Results Fifty-eight patients completed the 12-week follow-up (29 per group). Both groups showed significant symptom improvement: mean GERD-Q scores decreased from 12.7 ± 1.5 to 5.2 ± 1.3 (RFA) and from 12.9 ± 1.6 to 5.4 ± 1.4 (BML) ( P =0.62 and P =0.58). PPI discontinuation was achieved in 21/29 (72.4%) RFA patients and 20/29 (69.0%) BML patients (P = 0.78). DeMeester scores improved comparably—RFA: 28.6 ± 6.0 to 9.1 ± 3.2; BML: 28.1 ± 5.7 to 8.8 ± 2.9 (P = 0.63 between groups). Mean procedure time was shorter in the BML group (18.2 ± 3.1 vs. 24.5 ± 4.0 minutes, P < 0.01). Adverse events were mild and self-limiting: transient retrosternal discomfort (n=1, RFA) and transient dysphagia (n=2, BML). Patient satisfaction rates were high (86% vs. 83%, P = 0.72). (IDDF2026-ABS-0020 Table 1).Conclusions Endoscopic cardiac mucosal RFA and BML demonstrate comparable efficacy in reducing GERD symptoms and esophageal acid exposure at 12 weeks, with excellent safety profiles. BML offers a shorter procedural duration, suggesting it may be a practical alternative. Both techniques represent viable, minimally invasive options for selected GERD patients seeking PPI-free management.Abstract IDDF2026-ABS-0020 Table 1Comparison of outcomes between cardiac mucosal RFA and BML for GERD at 12-week follow-upOutcome MeasureRFA Group (n=29)BML Group (n=29)P-valueBaseline GERD-Q score12.7 ± 1.512.9 ± 1.60.62GERD-Q score at 12 weeks5.2 ± 1.35.4 ± 1.40.58∆ GERD-Q score-7.5 ± 1.8-7.5 ± 1.90.96PPI discontinuation rate, n (%)21 (72.4%)20 (69.0%)0.78Baseline DeMeester score28.6 ± 6.028.1 ± 5.70.74DeMeester score at 12 weeks9.1 ± 3.28.8 ± 2.90.63Mean Procedure time (minutes)24.5 ± 4.018.2 ± 3.1<0.01Adverse events, n (%)1 (3.4%) – chest discomfort2 (6.9%) – transient dysphagia0.55Patient satisfaction rate, n (%)25 (86.2%)24 (82.8%)0.72Data presented as mean ± SD unless otherwise indicated. RFA = radiofrequency ablation; BML = band mucosal ligation.",
  "authors": [
    {
      "affiliations": [
        "Guangzhou First People’s Hospital, China"
      ],
      "name": "Huasheng Lai"
    },
    {
      "affiliations": [
        "Guangzhou First People’s Hospital, China"
      ],
      "name": "Wenjuan Tang"
    },
    {
      "affiliations": [
        "Guangzhou First People’s Hospital, China"
      ],
      "name": "Gang Ning"
    },
    {
      "affiliations": [
        "Guangzhou First People’s Hospital, China"
      ],
      "name": "Huiting Chen"
    },
    {
      "affiliations": [
        "Guangzhou First People’s Hospital, China"
      ],
      "name": "Yongqiang Li"
    },
    {
      "affiliations": [
        "Guangzhou First People’s Hospital, China"
      ],
      "name": "Yongjian Zhou"
    }
  ],
  "title": "IDDF2026-ABS-0020 Comparative efficacy of cardiac mucosal ablation versus band ligation for gastroesophageal reflux disease: a retrospective cohort study",
  "uid": "e322b4b8-8ebf-56c5-bc68-b84659e13877"
}