Favorable results from a prospective evaluation of 200 patients with large hiatal hernias undergoing LINX magnetic sphincter augmentation
Autor: | Rachel Heidrick, Kate Freeman, Francis Paul Buckley, Stephanie Doggett, Reginald Bell |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Urology Magnetic sphincter augmentation Fundoplication Paraesophageal hernia Article Esophageal Sphincter Lower Hiatal hernia 03 medical and health sciences 0302 clinical medicine MSA Medicine Humans Hernia Prospective Studies Prospective cohort study Herniorrhaphy Aged business.industry LINX GERD Middle Aged medicine.disease Hernia repair digestive system diseases Surgery medicine.anatomical_structure Hernia Hiatal Treatment Outcome 030220 oncology & carcinogenesis Gastroesophageal Reflux Sphincter 030211 gastroenterology & hepatology Female Laparoscopy business Esophagitis Abdominal surgery |
Zdroj: | Surgical Endoscopy |
ISSN: | 1432-2218 0930-2794 |
Popis: | Introduction Magnetic sphincter augmentation (MSA) of the lower esophageal sphincter restores the antireflux barrier in patients with hiatal hernias ≤3 cm. We performed a prospective study in patients undergoing MSA with the LINX device during repair of paraesophageal and hernias over 3 cm axial component. Methods and procedures Multicenter, prospective study of consecutive patients treated with MSA at the time of repair of hiatal hernias >3 cm. Results 200 patients (110 female) were treated between March 2014 and February 2017 via laparoscopic hernia repair and MSA. Mean age was 59.5 years, mean BMI 29.4. 40% had esophagitis, 20% intestinal metaplasia, 72 of 77 tested had abnormal pH studies. Preoperative PPI use was reported by 87%. Eighteen patients had prior hiatal hernia/fundoplication. All had normal function. 78% of patients had axial hiatal hernia ≥5 cm or large paraesophageal component. Mean operative time was 81 min (38–193), EBL was 10 cc. Non-permanent mesh reinforcement of hiatal repair was performed in 83% of the patients. There were two readmissions for dehydration; 2 patients with pulmonary embolism, and 1 patient with cardiac ischemia. Nineteen patients required dilation. 156 pts were followed at a median of 8.6 months. GERD-HRQL scores improved from 26 preoperatively to 2 postoperatively. Complete PPI independence was achieved in 94% (147/156). Videoesophagram in 51 patients at median 11 months found 3 asymptomatic hernias 3 cm hernias undergoing MSA with hiatoplasty resulted in favorable outcomes with median of 9 months follow-up. Comparing this to published reports of MSA in patients with |
Databáze: | OpenAIRE |
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