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Magnetic Sphincter Augmentation After Gastric Surgery.
JSLS 2019 Oct-Dec; 23(4)JSLS

Abstract

Background

Persistent or de novo gastroesophageal reflux disease (GERD) may be a significant clinical issue after gastric/bariatric surgical procedures. We investigated the effect of magnetic sphincter augmentation (MSA) in the treatment of GERD after previous gastric/bariatric surgery.

Database

We conducted a systematic review according to the Preferred Reporting Items For Systematic Reviews and Meta-analyses statement. We searched multiple databases (PubMed, Cochrane, Embase, Scopus) up to May 2019. We also queried the prospectively collected database of patients who underwent MSA at our tertiary-care hospital and compared postsurgical to naïve patients operated during the same time period.

Results

Seven studies (3 case series and 4 case reports), for a total of 35 patients, met the inclusion criteria in the systematic review. The most common index operation was a bariatric procedure, either sleeve gastrectomy or Roux-en-Y gastric bypass. After MSA implant, the Gastroesophageal Reflux Disease-Health-Related Quality of Life (GERD-HRQL) score significantly improved compared to baseline (P = .005). Two patients (5.7%) required laparoscopic device removal. In the local institutional cohort series of 67 patients treated by MSA, the prevalence of preoperative grade B esophagitis, operative time, size of MSA, and length of stay were greater in patients with prior gastric surgery compared to naïve patients.

Conclusions

MSA is a safe, simple, and standardized antireflux procedure. It is also feasible in patients with refractory GERD following gastric/bariatric surgery. Further prospective and comparative studies are needed to validate the preliminary clinical experience in this subset of patients.

Authors+Show Affiliations

Department of Biomedical Sciences for Health, Division of General and Foregut Surgery, IRCCS Policlinico San Donato, University of Milano, Milano, Italy.Department of Biomedical Sciences for Health, Division of General and Foregut Surgery, IRCCS Policlinico San Donato, University of Milano, Milano, Italy.Department of Biomedical Sciences for Health, Division of General and Foregut Surgery, IRCCS Policlinico San Donato, University of Milano, Milano, Italy.Department of Biomedical Sciences for Health, Division of General and Foregut Surgery, IRCCS Policlinico San Donato, University of Milano, Milano, Italy.Department of Biomedical Sciences for Health, Division of General and Foregut Surgery, IRCCS Policlinico San Donato, University of Milano, Milano, Italy.Department of Biomedical Sciences for Health, Division of General and Foregut Surgery, IRCCS Policlinico San Donato, University of Milano, Milano, Italy.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

31624454

Citation

Riva, Carlo Galdino, et al. "Magnetic Sphincter Augmentation After Gastric Surgery." JSLS : Journal of the Society of Laparoendoscopic Surgeons, vol. 23, no. 4, 2019.
Riva CG, Asti E, Lazzari V, et al. Magnetic Sphincter Augmentation After Gastric Surgery. JSLS. 2019;23(4).
Riva, C. G., Asti, E., Lazzari, V., Aquilino, K., Siboni, S., & Bonavina, L. (2019). Magnetic Sphincter Augmentation After Gastric Surgery. JSLS : Journal of the Society of Laparoendoscopic Surgeons, 23(4), doi:10.4293/JSLS.2019.00035.
Riva CG, et al. Magnetic Sphincter Augmentation After Gastric Surgery. JSLS. 2019;23(4) PubMed PMID: 31624454.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Magnetic Sphincter Augmentation After Gastric Surgery. AU - Riva,Carlo Galdino, AU - Asti,Emanuele, AU - Lazzari,Veronica, AU - Aquilino,Krizia, AU - Siboni,Stefano, AU - Bonavina,Luigi, PY - 2019/10/19/entrez PY - 2019/10/19/pubmed PY - 2019/10/19/medline KW - Bariatric Surgery KW - Gastroesophageal Reflux Disease KW - LINX KW - Magnetic Sphincter Augmentation KW - Sleeve Gastrectomy JF - JSLS : Journal of the Society of Laparoendoscopic Surgeons JO - JSLS VL - 23 IS - 4 N2 - Background: Persistent or de novo gastroesophageal reflux disease (GERD) may be a significant clinical issue after gastric/bariatric surgical procedures. We investigated the effect of magnetic sphincter augmentation (MSA) in the treatment of GERD after previous gastric/bariatric surgery. Database: We conducted a systematic review according to the Preferred Reporting Items For Systematic Reviews and Meta-analyses statement. We searched multiple databases (PubMed, Cochrane, Embase, Scopus) up to May 2019. We also queried the prospectively collected database of patients who underwent MSA at our tertiary-care hospital and compared postsurgical to naïve patients operated during the same time period. Results: Seven studies (3 case series and 4 case reports), for a total of 35 patients, met the inclusion criteria in the systematic review. The most common index operation was a bariatric procedure, either sleeve gastrectomy or Roux-en-Y gastric bypass. After MSA implant, the Gastroesophageal Reflux Disease-Health-Related Quality of Life (GERD-HRQL) score significantly improved compared to baseline (P = .005). Two patients (5.7%) required laparoscopic device removal. In the local institutional cohort series of 67 patients treated by MSA, the prevalence of preoperative grade B esophagitis, operative time, size of MSA, and length of stay were greater in patients with prior gastric surgery compared to naïve patients. Conclusions: MSA is a safe, simple, and standardized antireflux procedure. It is also feasible in patients with refractory GERD following gastric/bariatric surgery. Further prospective and comparative studies are needed to validate the preliminary clinical experience in this subset of patients. SN - 1938-3797 UR - https://www.unboundmedicine.com/medline/citation/31624454/Magnetic_Sphincter_Augmentation_After_Gastric_Surgery L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/31624454/ DB - PRIME DP - Unbound Medicine ER -