Evidence map›Paper›PMID 40634721›Full record

SynthesisSurgical endoscopy2025

The efficacy of antireflux mucosectomy (ARMS) and antireflux mucosal ablation (ARMA) for gastroesophageal reflux disease (GERD) by 24-h pH monitoring: systematic review and meta-analysis.

Hasan Al-Obaidi, Omar Saab, Nooraldin Merza, Ali Wakil, Sana Rabeeah, Mustafa Al-Obaidi, Alhareth Alsagban, Marwah Algodi, Muhammad Usman Baig, Abdallah Kobeissy and 1 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Hasan Al-ObaidiDepartment of Medicine, Jamaica Hospital Medical Center, 138-28 Queens Blvd, New York, NY, 11435, USA. hasanalobaidimd@gmail.com.ORCID http://orcid.org/0009-0005-6465-8076
Omar SaabDepartment of Emergency Medicine, University of Texas, Houston, TX, USA.
Nooraldin MerzaDepartment of Gastroenterology, University of Toledo Medical Center, Toledo, OH, USA.
Ali WakilDepartment of Gastroenterology and Hepatology, Brooklyn Hospital, New York, NY, USA.
Sana RabeeahDepartment of Internal Medicine, University of Toledo, Toledo, OH, USA.
Mustafa Al-ObaidiDepartment of Medicine, Lund University, Lund, Sweden.
Alhareth AlsagbanDepartment of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Marwah AlgodiCollege of Medicine, University of Baghdad, Baghdad, Iraq.
Muhammad Usman BaigWeill Cornell University, New York, NY, USA.
Abdallah KobeissyDepartment of Gastroenterology and Hepatology, University of Toledo, Toledo, OH, USA.
Reem SharaihaWeill Cornell University, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGastroesophageal reflux disease (GERD) is a prevalent and chronic disorder impacting a significant proportion of the global population, approximately 15%. Most GERD patients show improvement with medical treatment, including proton pump inhibitors (PPIs); however, around 40% continue to experience symptoms despite ongoing PPI use. Antireflux mucosal ablation (ARMA) and antireflux mucosectomy (ARMS) are minimally invasive endoscopic procedures for treating GERD.

objectiveThis meta-analysis aimed to evaluate the efficacy of ARMA and ARMS through the DeMeester score, acid exposure time (AET), and clinical success rate.

methodsStudies reporting pre- and postprocedure esophageal 24 h pH monitoring following ARMA and ARMS were included. Pooled data analysis assessed changes in the DeMeester score and AET using the standardized mean difference (SMD). Clinical success rate, defined as significant symptom improvement or reduced reliance on PPIs, was also analyzed.

resultsPooled data from three ARMA studies showed a significant postprocedure decrease in median AET (SMD: - 20.74, 95% CI [- 25.51, - 15.97], p < 0.0001). Similarly, six ARMS studies demonstrated a significant reduction in DeMeester score (SMD: - 2.79, 95% CI [- 4.33, - 1.26], p < 0.0001). The overall clinical success rate for ARMS was 78%, while ARMA achieved 87%.

conclusionsBoth ARMA and ARMS displayed promising efficacy in improving GERD-related outcomes based on reductions in AET and DeMeester scores and achieving high clinical success rates. However, the high heterogeneity observed suggests further research is needed to identify patient-specific factors influencing treatment response.

Indexed as

Endoscopic Mucosal ResectionGastroesophageal RefluxEsophageal pH MonitoringHumansTreatment OutcomeAcid exposure time (AET)Antireflux mucosal ablationAntireflux mucosectomyClinical success rateDeMeester scoreEsophageal pH monitoringGastroesophageal reflux disease

Identifiers

PMID40634721

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.