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...
Autores principales: | , , , , , , , |
---|---|
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 |
_version_ | 1783354403882795008 |
---|---|
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. |
format | Online Article Text |
id | pubmed-6132868 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT schwameiskatrin resultsofmagneticsphincteraugmentationforgastroesophagealrefluxdisease AT nikolicmilena resultsofmagneticsphincteraugmentationforgastroesophagealrefluxdisease AT moralescastellanodeivisg resultsofmagneticsphincteraugmentationforgastroesophagealrefluxdisease AT steindlariane resultsofmagneticsphincteraugmentationforgastroesophagealrefluxdisease AT machecksarah resultsofmagneticsphincteraugmentationforgastroesophagealrefluxdisease AT kristoivan resultsofmagneticsphincteraugmentationforgastroesophagealrefluxdisease AT zornerbarbara resultsofmagneticsphincteraugmentationforgastroesophagealrefluxdisease AT schoppmannsebastianf resultsofmagneticsphincteraugmentationforgastroesophagealrefluxdisease |