Results of Magnetic Sphincter Augmentation for Gastroesophageal Reflux Disease

BACKGROUND: Magnetic sphincter augmentation (MSA) is a modern treatment option for gastroesophageal reflux disease (GERD); however, laparoscopic fundoplication remains the gold standard. The aim of the study was to evaluate outcomes of MSA patients at a reflux center. METHODS: A retrospective review...

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Autores principales: Schwameis, Katrin, Nikolic, Milena, Morales Castellano, Deivis G., Steindl, Ariane, Macheck, Sarah, Kristo, Ivan, Zörner, Barbara, Schoppmann, Sebastian F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132868/
https://www.ncbi.nlm.nih.gov/pubmed/29619511
http://dx.doi.org/10.1007/s00268-018-4608-8
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author Schwameis, Katrin
Nikolic, Milena
Morales Castellano, Deivis G.
Steindl, Ariane
Macheck, Sarah
Kristo, Ivan
Zörner, Barbara
Schoppmann, Sebastian F.
author_facet Schwameis, Katrin
Nikolic, Milena
Morales Castellano, Deivis G.
Steindl, Ariane
Macheck, Sarah
Kristo, Ivan
Zörner, Barbara
Schoppmann, Sebastian F.
author_sort Schwameis, Katrin
collection PubMed
description BACKGROUND: Magnetic sphincter augmentation (MSA) is a modern treatment option for gastroesophageal reflux disease (GERD); however, laparoscopic fundoplication remains the gold standard. The aim of the study was to evaluate outcomes of MSA patients at a reflux center. METHODS: A retrospective review was performed of all patients that underwent MSA between March 2012 and November 2017. Out of 110 patients, 68 with a follow-up >3 months were included. Postoperative gastrointestinal symptoms, proton pump inhibitor (PPI) intake, GERD-Health-related Quality of Life (GERD-HRQL) and alimentary satisfaction (AS) were assessed. Postoperative esophageal functioning tests were performed in 50% of patients. RESULTS: Sixty-eight patients underwent MSA; hiatal repair was performed in 31 cases. The median OR time was 27 min, and no intraoperative complications occurred. The median follow-up was 13 months (IQR 4.2–45). Endoscopic dilatation was performed in 2 patients (3%) and device removal in another 2 cases. The postoperative GERD-HRQL score was significantly reduced (3 vs. 24; p < 0.001) and the median AS was 8/10. Preoperative experienced heartburn, regurgitations and dysphagia were eliminated in 92, 96 and 100%. Postoperative new-onset difficulties swallowing with solids only were reported to occur occasionally by 16% and rarely by 21% of patients. Satisfaction with heartburn relief was 95%, and the overall outcome was rated excellent/good in 89%. PPI dependency was eliminated in 87%. The median total percentage pH < 4 and number of reflux episodes were significantly reduced. Postoperative pH results were negative or slightly above the norm in 79% and 12%, respectively. CONCLUSION: Sphincter augmentation results in significantly reduced reflux symptoms, increased GERD-specific Quality of Life and excellent alimentary satisfaction with low perioperative morbidity. This procedure should be considered an excellent alternative to fundoplication in the treatment of GERD.
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spelling pubmed-61328682018-09-13 Results of Magnetic Sphincter Augmentation for Gastroesophageal Reflux Disease Schwameis, Katrin Nikolic, Milena Morales Castellano, Deivis G. Steindl, Ariane Macheck, Sarah Kristo, Ivan Zörner, Barbara Schoppmann, Sebastian F. World J Surg Original Scientific Report BACKGROUND: Magnetic sphincter augmentation (MSA) is a modern treatment option for gastroesophageal reflux disease (GERD); however, laparoscopic fundoplication remains the gold standard. The aim of the study was to evaluate outcomes of MSA patients at a reflux center. METHODS: A retrospective review was performed of all patients that underwent MSA between March 2012 and November 2017. Out of 110 patients, 68 with a follow-up >3 months were included. Postoperative gastrointestinal symptoms, proton pump inhibitor (PPI) intake, GERD-Health-related Quality of Life (GERD-HRQL) and alimentary satisfaction (AS) were assessed. Postoperative esophageal functioning tests were performed in 50% of patients. RESULTS: Sixty-eight patients underwent MSA; hiatal repair was performed in 31 cases. The median OR time was 27 min, and no intraoperative complications occurred. The median follow-up was 13 months (IQR 4.2–45). Endoscopic dilatation was performed in 2 patients (3%) and device removal in another 2 cases. The postoperative GERD-HRQL score was significantly reduced (3 vs. 24; p < 0.001) and the median AS was 8/10. Preoperative experienced heartburn, regurgitations and dysphagia were eliminated in 92, 96 and 100%. Postoperative new-onset difficulties swallowing with solids only were reported to occur occasionally by 16% and rarely by 21% of patients. Satisfaction with heartburn relief was 95%, and the overall outcome was rated excellent/good in 89%. PPI dependency was eliminated in 87%. The median total percentage pH < 4 and number of reflux episodes were significantly reduced. Postoperative pH results were negative or slightly above the norm in 79% and 12%, respectively. CONCLUSION: Sphincter augmentation results in significantly reduced reflux symptoms, increased GERD-specific Quality of Life and excellent alimentary satisfaction with low perioperative morbidity. This procedure should be considered an excellent alternative to fundoplication in the treatment of GERD. Springer International Publishing 2018-04-04 2018 /pmc/articles/PMC6132868/ /pubmed/29619511 http://dx.doi.org/10.1007/s00268-018-4608-8 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Scientific Report
Schwameis, Katrin
Nikolic, Milena
Morales Castellano, Deivis G.
Steindl, Ariane
Macheck, Sarah
Kristo, Ivan
Zörner, Barbara
Schoppmann, Sebastian F.
Results of Magnetic Sphincter Augmentation for Gastroesophageal Reflux Disease
title Results of Magnetic Sphincter Augmentation for Gastroesophageal Reflux Disease
title_full Results of Magnetic Sphincter Augmentation for Gastroesophageal Reflux Disease
title_fullStr Results of Magnetic Sphincter Augmentation for Gastroesophageal Reflux Disease
title_full_unstemmed Results of Magnetic Sphincter Augmentation for Gastroesophageal Reflux Disease
title_short Results of Magnetic Sphincter Augmentation for Gastroesophageal Reflux Disease
title_sort results of magnetic sphincter augmentation for gastroesophageal reflux disease
topic Original Scientific Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132868/
https://www.ncbi.nlm.nih.gov/pubmed/29619511
http://dx.doi.org/10.1007/s00268-018-4608-8
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