LINX® magnetic esophageal sphincter augmentation versus Nissen fundoplication for gastroesophageal reflux disease: a systematic review and meta-analysis

Skubleny, Daniel; Switzer, Noah; Dang, Jerry; Gill, Richdeep S.; Shi, Xinzhe; Gara, Christopher de; Birch, Daniel W.; Wong, Clarence; Hutter, Matthew M.; Karmali, Shahzeer

doi:10.1007/s00464-016-5370-3

Cited by 107 publications

(59 citation statements)

References 23 publications

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“…In an effort to decrease the gap between medical and surgical GERD therapy by reducing the risk of potential side effects, magnetic sphincter augmentation (MSA) as well as lower esophageal sphincter stimulation (LESS) have come to use. As further treatments against GERD develop, it is crucial not to underestimate the golden standard and have valid, up-to-date long-term outcome results, that will serve as the benchmark for further research [3, 21–24]. …”

Section: Discussionmentioning

confidence: 99%

Persistent dysphagia is a rare problem after laparoscopic Nissen fundoplication

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Persistent dysphagia is a rare problem after laparoscopic Nissen fundoplication

et al. 2018

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“…39 This study and two retrospective case-control studies, albeit not in PPINR, were included in a meta-analysis comparing MSA to LFA that found MSA was superior in preserving the ability to belch and vomit without significant difference in gas-bloat, dysphagia or PPI discontinuation. 61–63 Other characteristics favoring MSA over LF include a less extensive surgery, removal via minimally invasive techniques, and less inter-surgeon variability due to the standardized device. Use of MSA, however, is less versatile than LF as it is not indicated for patients with severe EE or large hiatal hernia.…”

Section: Discussionmentioning

confidence: 99%

Review of antireflux procedures for proton pump inhibitor nonresponsive gastroesophageal reflux disease

Hillman

Yadlapati

Whitsett

et al. 2017

Diseases of the Esophagus

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Introduction Up to 40% of patients with gastroesophageal reflux disease (GERD) report persistent symptoms despite proton pump inhibitor (PPI) therapy. This review outlines the evidence for surgical and endoscopic therapies for the treatment of PPI non-responsive GERD. Material and Methods A literature search for GERD therapies from 2005–2015 in PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews identified unique 2928 citations. Of those, 45 unique articles specific to surgical and endoscopic therapies for PPI non-responsive GERD were reviewed. Results Laparoscopic fundoplication (n=19) provides symptomatic and physiologic relief out to 10 years, though efficacy wanes with time. Magnetic sphincter augmentation (n=6) and transoral incisionless fundoplication (n=9) improve symptoms in PPI non-responders, and may offer fewer side effects than fundoplication, though long-term follow-up is lacking. Radiofrequency energy delivery (n=8) has insufficient evidence for routine use in treating PPI non-responsive GERD. Electrical stimulator implantation (n=1) and endoscopic mucosal surgery (n=2) are emerging therapies for the treatment of GERD. Discussion Laparoscopic fundoplication remains the most proven therapeutic approach. Newer anti-reflux procedures such as magnetic sphincter augmentation and transoral incisionless fundoplication offer alternatives with varying degrees of success, durability, and side effect profiles that may better suit individual patients. Larger head-to-head comparison trials are needed to better characterize the difference in symptom response and side effect profiles.

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“…The most common complication reported after MSA in all of the studies reviewed was dysphagia with immediate post-op incidence ranging from 33.9% to 83% 53,58. Less frequent unfavorable side effects include a decreased ability to belch, bloating, and chest pain.…”

Section: Resultsmentioning

confidence: 99%

Spotlight on the Linx™ Reflux Management System for the treatment of gastroesophageal reflux disease: evidence and research

Zadeh¹,

Andreoni²,

Treitl³

et al. 2018

MDER

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BackgroundThe initial approach to gastroesophageal reflux disease (GERD) management typically involves lifestyle modification and medical therapy utilizing acid reducing agents such as histamine blockers and proton pump inhibitors. In severe cases refractory to such treatments, surgical therapy may be indicated. The gold standard for surgical treatment of GERD is the laparoscopic Nissen fundoplication. In recent years, a new technique known as magnetic sphincter augmentation (MSA) has been developed using the Linx™ Reflux Management System. This is an implantable ring of magnetic beads that is placed around the esophagus at the gastroesophageal junction to restore lower esophageal integrity. The aim of this review is to discuss the current literature regarding indications, surgical technique, efficacy, and complications of MSA using the Linx device.MethodsA standardized literature search was performed yielding 367 abstracts. After elimination due to duplicates between databases and irrelevance, 96 articles remained. The information found to be significant and non-redundant was included in this review.ConclusionAfter several years of clinical application, the Linx device has been shown to not only be effective for the management of GERD but also be as effective as fundoplication. With respect to safety, the most common complication of MSA is dysphagia. This often resolved without intervention, but esophageal dilation or device explanation are occasionally necessary. Not fully appreciated in earlier reviews, erosion of the device into the esophagus appears to be the most significant complication of the device after extended follow-up. While very rare, the potentially severe consequences of this phenomenon suggest that the device should be used with some restraint and that patients should be made aware of this potential morbidity. Fortunately, in the few cases of device erosion described in the literature reviewed, the Linx device was easily and safely removed.

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LINX® magnetic esophageal sphincter augmentation versus Nissen fundoplication for gastroesophageal reflux disease: a systematic review and meta-analysis

Cited by 107 publications

References 23 publications

Persistent dysphagia is a rare problem after laparoscopic Nissen fundoplication

Persistent dysphagia is a rare problem after laparoscopic Nissen fundoplication

Review of antireflux procedures for proton pump inhibitor nonresponsive gastroesophageal reflux disease

Spotlight on the Linx™ Reflux Management System for the treatment of gastroesophageal reflux disease: evidence and research

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LINX® magnetic esophageal sphincter augmentation versus Nissen fundoplication for gastroesophageal reflux disease: a systematic review and meta-analysis

Cited by 107 publications

References 23 publications

Persistent dysphagia is a rare problem after laparoscopic Nissen fundoplication

Persistent dysphagia is a rare problem after laparoscopic Nissen fundoplication

Review of antireflux procedures for proton pump inhibitor nonresponsive gastroesophageal reflux disease

Spotlight on the Linx&trade; Reflux Management System for the treatment of gastroesophageal reflux disease: evidence and research

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Spotlight on the Linx™ Reflux Management System for the treatment of gastroesophageal reflux disease: evidence and research