Transoral Endoscopic Clip Band Ligation Anti-reflux Therapy (C-BLART) for Gastroesophageal Reflux Disease: A Retrospective Analysis of Efficacy and Safety in 37 Patients.

AIM: Transoral endoscopic clip band ligation anti-reflux therapy (C-BLART) has emerged as a minimally invasive alternative for managing gastroesophageal reflux disease (GERD). However, evidence regarding its mid-term efficacy and safety profile remains limited. This study aimed to evaluate the clinical outcomes of C-BLART in patients with GERD. METHODS: We retrospectively analyzed 37 patients with confirmed GERD who underwent C-BLART between January 2023 and December 2024 at the Department of Gastroenterology, The Third People's Hospital of Yunnan Province. Primary outcomes included changes in Reflux Disease Questionnaire (RDQ), GERD-Health Related Quality of Life (GERD-HRQL), and GERD Questionnaire (GERD-Q) scores at 3, 6, and 12 months post-procedure. Secondary outcomes included clinical efficacy, proton pump inhibitor (PPI) utilization patterns, and procedure-related complications. RESULTS: All 37 patients successfully underwent C-BLART, yielding a 100% technical success rate with a mean operative time of 11.3 ± 6.6 min. The median number of bands applied was 3 (range 2-5). Postoperative complications occurred in two patients (5.4%): one localized inflammatory response (2.7%) and one case of mild dysphagia (2.7%), all of which resolved spontaneously or with conservative management. All patients completed 3- and 6-month follow-up assessments, with 36 patients (97.3%) demonstrating significant improvements in RDQ, GERD-HRQL, and GERD-Q scores compared to baseline (p < 0.05). Among the 29 patients (78.4%) who completed 12-month follow-up, therapeutic benefits were sustained (p < 0.05). Complete PPI discontinuation was achieved in 72.4% of patients at 12 months. Pre‑procedural 24‑hour pH monitoring (n = 24) demonstrated pathologic acid exposure with median acid exposure time 8.6% (IQR 5.2-12.4%). Post‑procedural pH monitoring was not performed due to patient refusal. CONCLUSION: C‑BLART demonstrated promising short‑term safety and symptom improvement; however, larger prospective controlled studies with objective reflux assessment are required before its efficacy can be definitively established. These findings suggest that C‑BLART warrants further investigation in prospective, controlled studies with standardized objective outcome measures to determine its definitive role in the GERD treatment algorithm.