Journal article
Efficacy of Magnetic Sphincter Augmentation Across the Spectrum of GERD Disease Severity
Journal of the American College of Surgeons, v 232(3), pp 288-297
01 Mar 2021
PMID: 33387623
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND: The performance and durability of various types of fundoplication are variable when stratified by disease severity. To date, magnetic sphincter augmentation (MSA) has not been evaluated in this context. We designed this study to determine the efficacy of MSA in the treatment of severe GERD.
STUDY DESIGN: Guided by previous studies, a DeMeester score (DMS) >= 50 was used as a cutoff point to define severe reflux disease. Subjects were divided into 2 groups using this cutoff, and outcomes of severe cases were compared with those with less severe disease (DMS < 50).
RESULTS: A total of 334 patients underwent MSA. Patients with severe disease had a higher mean preoperative DMS compared with those with mild to moderate GERD (79.2 [53.2] vs 22.8 [13.7], p < 0.0001). At a mean postoperative follow-up of 13.6 (10.4) months, there was no difference between the mean GERD Health-Related Quality of Life (HRQL) total scores in patients with severe disease compared with those with less severe GERD (8.8 [10] vs 9.2 [10.8], p = 0.9204). Postoperative mean DMS was not different between groups (17.3[23.0] vs 14.1[33.9], p = 0.71), and there was no difference in the prevalence of esophagitis (p = 0.52). Patients with severe disease were less likely to be free from use of proton pump inhibitors after surgery (85% vs 93.1%, p = 0.041). There were similar rates of postoperative dysphagia (10% vs 14%, p = 0.42) and need for device removal (3% vs 5%, p = 0.7463).
CONCLUSIONS: MSA is an effective treatment in patients with severe GERD and leads to significant clinical improvement across the spectrum of disease severity, with few objective outcomes being superior in patients with mild-to-moderate reflux disease. ((C) 2020 The Author(s). Published by Elsevier Inc. on behalf of the American College of Surgeons.)
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Details
- Title
- Efficacy of Magnetic Sphincter Augmentation Across the Spectrum of GERD Disease Severity
- Creators
- Katrin Schwameis - Allegheny Health NetworkShahin Ayazi - Allegheny Health NetworkPing Zheng - Allegheny Health NetworkAndrew D. Grubic - Allegheny Health NetworkMadison Salvitti - Allegheny Health NetworkToshitaka Hoppo - Allegheny Health NetworkBlair A. Jobe - Allegheny Health Network
- Publication Details
- Journal of the American College of Surgeons, v 232(3), pp 288-297
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 10
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000621518000009
- Scopus ID
- 2-s2.0-85099297098
- Other Identifier
- 991022048294004721
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