Short-Term Outcomes Predict Long-Term Satisfaction in Patients Undergoing Laparoscopic Magnetic Sphincter Augmentation

Antiporda, Michael; Jackson, Chloe; Smith, C. Daniel; Bowers, Steven P.

doi:10.1089/lap.2018.0598

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…There was a significant reduction in acid exposure time and improvement of GERD-HRQL score; freedom from daily dependence on PPI was achieved in 85% of the patients [40]. Additional published data [41][42][43][44][45][46] confirmed similar satisfactory results. Importantly, a 1-year randomized clinical trial comparing the Linx procedure with PPI showed the superiority of Linx in controlling moderate to severe regurgitation and reducing esophageal acid exposure [47].…”

Section: Early and Intermediate-term Outcomessupporting

confidence: 53%

Real-world evidence with magnetic sphincter augmentation for gastroesophageal reflux disease: a scoping review

Froiio¹,

Tareq²,

Riggio³

et al. 2023

Eur Surg

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Summary Background The burden of gastroesophageal reflux disease (GERD) is high, with up to 30% of the Western population reporting reflux-related symptoms with or without hiatal hernia. Magnetic sphincter augmentation (MSA) is a standardized laparoscopic procedure for patients who are dissatisfied with medical therapy and for those with early-stage disease who would not usually be considered ideal candidates for fundoplication. The MSA device is manufactured in different sizes and is designed to augment the physiologic barrier to reflux by magnetic force. Methods An extensive scoping review was performed to provide a map of current evidence with respect to MSA, to identify gaps in knowledge, and to make recommendations for future research. All the authors contributed to the literature search in PubMed and Web of Science and contributed to summarizing the evidence. Results Magnetic sphincter augmentation, especially in combination with crural repair, is effective in reducing GERD symptoms, proton pump inhibitor use, and esophageal acid exposure, and in improving patients’ quality of life. Safety issues such as device erosion or migration have been rare and not associated with mortality. The MSA device can be removed laparoscopically if necessary, thereby preserving the option of fundoplication or other therapies in the future. Contraindication to scanning in high-power Tesla magnetic resonance systems remains a potential limitation of the MSA procedure. High-resolution manometry and functional lumen imaging probes appear to be promising tools to predict procedural outcomes by improving reflux control and reducing the incidence of dysphagia. Conclusion A consensus on acquisition and interpretation of high-resolution manometry and impedance planimetry data is needed to gain better understanding of physiology, to improve patient selection, and to pave the way for a personalized surgical approach in antireflux surgery.

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Section: Early and Intermediate-term Outcomessupporting

confidence: 53%

Real-world evidence with magnetic sphincter augmentation for gastroesophageal reflux disease: a scoping review

Froiio¹,

Tareq²,

Riggio³

et al. 2023

Eur Surg

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“…Despite these restricted indications, several studies have determined the effectiveness of the procedure. The pivotal trial, a multi-center study including 100 patients, reported a 90% reduction of GERD symptoms with 86% of patients without PPI use at two years of follow-up 3 , 4 , 7 , 10 , 11 , 14 , 16 , 19 , 20 , 23 , 25 , 26 , 34 , 40 , 41 , 43 , 45 , 48 , 50 , 52 , 55 . Similarly, a recent study including 553 patients showed that 84% of patients had at least 50% improvement in the GERD-HRQL score at a median follow-up of 10.6 months.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Sphincter Augmentation Device for Gastroesophageal Reflux Disease: Effective, but Postoperative Dysphagia and Risk of Erosion Should Not Be Underestimated. A Systematic Review and Meta-Analysis

Valinoti,

Angeramo,

Dreifuss

et al. 2023

ABCD, arq. bras. cir. dig.

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BACKGROUND: Magnetic ring (MSA) implantation in the esophagus is an alternative surgical procedure to fundoplication for the treatment of gastroesophageal reflux disease. AIMS: The aim of this study was to analyse the effectiveness and safety of magnetic sphincter augmentation (MSA) in patients with gastroesophageal reflux disease (GERD). METHODS: A systematic literature review of articles on MSA was performed using the Medical Literature Analysis and Retrieval System Online (Medline) database between 2008 and 2021, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A random-effect model was used to generate a pooled proportion with 95% confidence interval (CI) across all studies. RESULTS: A total of 22 studies comprising 4,663 patients with MSA were analysed. Mean follow-up was 27.3 (7–108) months. The weighted pooled proportion of symptom improvement and patient satisfaction were 93% (95%CI 83–98%) and 85% (95%CI 78–90%), respectively. The mean DeMeester score (pre-MSA: 34.6 vs. post-MSA: 8.9, p=0.03) and GERD-HRQL score (pre-MSA: 25.8 vs. post-MSA: 4.4, p<0.0001) improved significantly after MSA. The proportion of patients taking proton pump inhibitor (PPIs) decreased from 92.8 to 12.4% (p<0.0001). The weighted pooled proportions of dysphagia, endoscopic dilatation and gas-related symptoms were 18, 13, and 3%, respectively. Esophageal erosion occurred in 1% of patients, but its risk significantly increased for every year of MSA use (odds ratio — OR 1.40, 95%CI 1.11–1.77, p=0.004). Device removal was needed in 4% of patients. CONCLUSIONS: Although MSA is a very effective treatment modality for GERD, postoperative dysphagia is common and the risk of esophageal erosion increases over time. Further studies are needed to determine the long-term safety of MSA placement in patients with GERD.

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“… 40 Short-term symptomatic outcomes predicted longer-term patient satisfaction, based on a retrospective analysis of 98 patients with median follow-up of 46 months after MSA. 41 …”

Section: Longer-term Outcomesmentioning

confidence: 99%

The role of magnetic sphincter augmentation in the gastroesophageal reflux disease treatment pathway: the gastroenterology perspective

Patel

Gyawali

2023

Diseases of the Esophagus

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Magnetic sphincter augmentation (MSA) is a surgical intervention for well-characterized gastroesophageal reflux disease (GERD), where the esophagogastric junction barrier is augmented using a bracelet of magnetized titanium beads. MSA could be an attractive option for patients with documented GERD who wish to avoid long-term pharmacologic therapy or whose symptoms are not adequately managed with lifestyle modifications and pharmacologic therapy. The ‘ideal’ MSA patient is one with prominent regurgitation, without dysphagia or esophageal motor dysfunction, with objective evidence of GERD on upper endoscopy and/or ambulatory reflux monitoring. Appropriate candidates with significant hiatus hernia may pursue MSA with concomitant hiatus hernia repair. The increasing adoption of MSA in the GERD treatment pathway reflects research that shows benefits in long-term outcomes and healthcare costs compared with other established therapies in appropriate clinical settings.

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Short-Term Outcomes Predict Long-Term Satisfaction in Patients Undergoing Laparoscopic Magnetic Sphincter Augmentation

Cited by 4 publications

References 10 publications

Real-world evidence with magnetic sphincter augmentation for gastroesophageal reflux disease: a scoping review

Real-world evidence with magnetic sphincter augmentation for gastroesophageal reflux disease: a scoping review

Magnetic Sphincter Augmentation Device for Gastroesophageal Reflux Disease: Effective, but Postoperative Dysphagia and Risk of Erosion Should Not Be Underestimated. A Systematic Review and Meta-Analysis

The role of magnetic sphincter augmentation in the gastroesophageal reflux disease treatment pathway: the gastroenterology perspective

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