Current aspects of surgical treatment of gastro-esophageal reflux disease

Danilova, D. A.; Базаев, А В; Gorbunova, L. I.

doi:10.17116/hirurgia202002189

Cited by 4 publications

(3 citation statements)

References 45 publications

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“…Gastroesophageal reflux disease (GERD) affects up to 28% of the western population [1][2][3][4]. Although surgical treatment has been proven to be safe and effective in reflux control [1,[5][6][7], the rates of laparoscopic Nissen fundoplication (LNF), the current standard in anti-reflux surgery [8][9][10][11], have decreased in the last decade [12][13][14][15]. This decline can be explained by the feared side effects and long-term failure [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Severe Dysphagia is Rare After Magnetic Sphincter Augmentation

et al. 2022

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Background Dysphagia remains the most significant concern after anti-reflux surgery, including magnetic sphincter augmentation (MSA). The aim of this study was to evaluate postoperative dysphagia rates, its risk factors, and management after MSA. Methods From a prospectively collected database of all 357 patients that underwent MSA at our institution, a total of 268 patients were included in our retrospective study. Postoperative dysphagia score, gastrointestinal symptoms, proton pump inhibitor intake, GERD-HRQL, Alimentary Satisfaction, and serial contrast swallow imaging were evaluated within standardized follow-up appointments. To determine patients’ characteristics and surgical factors associated with postoperative dysphagia, a multivariable logistic regression analysis was performed. Results At a median follow-up of 23 months, none of the patients presented with severe dysphagia, defined as the inability to swallow solids or/and liquids. 1% of the patients underwent endoscopic dilatation, and 1% had been treated conservatively for dysphagia. 2% of the patients needed re-operation, most commonly due to recurrent hiatal hernia. Two patients underwent device removal due to unspecific discomfort and pain. No migration of the device or erosion by the device was seen. The LINX® device size ≤ 13 was found to be the only factor associated with postoperative dysphagia (OR 5.90 (95% CI 1.4–24.8)). The postoperative total GERD-HRQL score was significantly lower than preoperative total score (2 vs. 19; p = 0.001), and daily heartburn, regurgitations, and respiratory complains improved in 228/241 (95%), 131/138 (95%) and 92/97 (95%) of patients, respectively. Conclusions Dysphagia requiring endoscopic or surgical intervention was rare after MSA in a large case series. LINX® devices with a size < 13 were shown to be an independent risk factor for developing postoperative dysphagia.

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Section: Introductionmentioning

confidence: 99%

Severe Dysphagia is Rare After Magnetic Sphincter Augmentation

et al. 2022

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“…Gastroesophageal reflux disease (GERD) is one of the most common upper gastrointestinal (GI) tract disorders with a worldwide high prevalence and yearly increasing incidence rates. [1][2][3] Patients not only suffer from a variety of burdensome symptoms that lead to a reduced quality of life, but also are at an increased risk of developing Barrett's esophagus (BE) and esophageal adenocarcinoma. [4][5][6][7][8][9] The combination of clinical evaluation, upper GI endoscopy, and esophageal function testing, including high-resolution manometry as well as 24-h impedance-pH-metry, is applied to diagnose GERD.…”

Section: Introductionmentioning

confidence: 99%

Expanded Indication for Magnetic Sphincter Augmentation: Outcomes in Weakly Acidic Reflux Compared to Standard GERD Patients

Nikolic

Matic

Feka

et al. 2022

Journal of Gastrointestinal Surgery

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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.

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“…Type IV HHs are the herniation of different organs such as the colon, small intestine or spleen, and the stomach in the thoracic cavity [3]. Many well-known operating techniques in the literature can be applied to HH types [5,6]. Although both open and minimally invasive procedures have published similar results in morbidity/mortality, complications, long-term benefit and symptom control, laparoscopic/thoracoscopic surgical techniques have become widespread in resident training due to short hospital stays and rapid return to work [2].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Early Outcomes of Laparoscopic Floppy Nissen Fundoplication and Laparoscopic Toupet Fundoplication in the Treatment of Type III and IV Hiatal Hernia

Tayar

Kalaycı

2022

Celal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi

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Introduction: This study aims to compare the laparoscopic Floppy Nissen fundoplication technique (LFNFT) and the laparoscopic Toupet fundoplication technique (LTFT) used in treating Type III and IV hiatal hernias (HHs). Materials and Methods: This retrospective analysis was conducted after ethical approval. Patients who underwent Type III and IV hiatal hernia surgery were searched between January 2020 and May 2022. Patients who underwent LFNFT and LTFT for hiatal hernia repair were selected. Patients under 18 and patients who were followed up in our clinic after surgery were excluded from the study. The clinical and follow-up differences between the groups were evaluated statistically. Results: Of the 38 patients who met the study criteria, 27 (71.1%) were female. The mean age of all patients was 41.39±14.03 years (21-77). 10 (26.3%) patients had Type 3 HH, and the remaining patients (73.7%) had Type 4 HH. LFNFT was performed on 27 (71.1%) patients, and LTFT on 11 (28.9%). Complications developed in 14 (36.8%) patients in the postoperative follow-up, and the most common difficulty was gas bloating, with a rate of 13.1%. In comparing the groups, LTFT was preferred in the male patients (p=0.005) and younger patients (p

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Current aspects of surgical treatment of gastro-esophageal reflux disease

Cited by 4 publications

References 45 publications

Severe Dysphagia is Rare After Magnetic Sphincter Augmentation

Severe Dysphagia is Rare After Magnetic Sphincter Augmentation

Expanded Indication for Magnetic Sphincter Augmentation: Outcomes in Weakly Acidic Reflux Compared to Standard GERD Patients

Comparison of Early Outcomes of Laparoscopic Floppy Nissen Fundoplication and Laparoscopic Toupet Fundoplication in the Treatment of Type III and IV Hiatal Hernia

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