Expanded Indication for Magnetic Sphincter Augmentation: Outcomes in Weakly Acidic Reflux Compared to Standard GERD Patients
| Autor: | Aleksa Matic, F. M. Riegler, Berta Mosleh, Joy Feka, Bogdan Osmokrovic, Sebastian F. Schoppmann, Milena Nikolic, Ivan Kristo, Lisa Gensthaler |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Proton-pump inhibitor Fundoplication Gastroenterology Esophageal Sphincter Lower Hiatal hernia Heartburn Internal medicine Medicine Humans Retrospective Studies business.industry Magnetic Phenomena Reflux Endoscopic dilatation Proton Pump Inhibitors medicine.disease Dysphagia medicine.anatomical_structure Treatment Outcome GERD Gastroesophageal Reflux Quality of Life Sphincter Surgery Laparoscopy medicine.symptom business |
| Zdroj: | Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 26(3) |
| ISSN: | 1873-4626 |
| Popis: | Background Magnetic sphincter augmentation (MSA) is a modern surgical anti-reflux technique with proven efficacy and low postoperative morbidity in patients with acidic reflux. The aim of this retrospective review study was to evaluate the symptomatic outcome of MSA in patients with weakly acidic reflux. Methods From a prospectively collected clinical database, comprising all 327 patients that underwent MSA at our institution, a total of 67 patients with preoperative weakly acidic reflux measured in the 24-h impedance-pH-metry were identified. Postoperative gastrointestinal symptoms, proton pump inhibitor intake (PPI), GERD Health-Related Quality-of-Life (GERD-HRQL), alimentary satisfaction (AS), and patients’ overall satisfaction were evaluated within highly standardized follow-up appointments. Furthermore, outcome of these patients was compared to the postoperative outcome of a comparable group of patients with a preoperative acidic reflux. Results At a median follow-up of 24 months, none of the patients with weakly acidic reflux presented with persistent dysphagia, or underwent endoscopic dilatation or reoperation. The postoperative GERD-HRQL score was significantly reduced (2 vs. 20; p = 0.001) and the median AS was 9/10. Preoperative daily heartburn, regurgitations, and respiratory complaints were improved in 95%, 95%, and 96% of patients, respectively. A total of 10% of the patients continued to use PPIs postoperatively. No significant difference was observed in terms of postoperative outcome or quality of life when comparing weakly acidic reflux patients with those diagnosed with preoperative acidic reflux. Conclusion Magnetic sphincter augmentation significantly improves GERD-related symptoms and quality of life in patients with weakly acidic reflux with very low postoperative morbidity. |
| Databáze: | OpenAIRE |
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