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High-resolution manometry findings after Linx procedure for gastro-esophageal reflux disease.
Neurogastroenterol Motil 2019; :e13750NM

Abstract

BACKGROUND

Magnetic sphincter augmentation with the Linx® system is a novel laparoscopic procedure for the treatment of gastro-esophageal reflux disease (GERD). Only few data are available regarding the impact of Linx on high-resolution manometry (HRM) variables.

METHODS

The prospectively collected database of patients who underwent Linx procedure at a single institution was queried. All patients who completed pre- and postoperative HRM, GERD health-related quality of life (GERD-HRQL) questionnaire, and functional outcome swallowing scale (FOSS) questionnaire were included in the study.

KEY RESULTS

Forty-five out of 304 patients were included. At a median follow-up of 12 months (IQR 10) after surgery, a statistically significant increase of lower esophageal sphincter (LES) total length (P = .002), intra-abdominal length (P = .001), integrated relaxation pressure (IRP), intrabolus pressure (IBP), and esophagogastric contractile integral (EGJ-CI) was noted (P < .001). Distal esophageal amplitude (P = .004), mean distal contractile integral (DCI) (P < .001), post multiple repeated swallows DCI (P = .001), and the percent of normal peristalsis increased (P = .040). All patients were relieved of reflux symptoms. Ineffective esophageal motility reversed to normal in 36% of patients after surgery. The only factor significantly associated with postoperative dysphagia was preoperative dysphagia (P = .006). Postoperatively, a significant correlation between IRP and DCI (r = 0.361 and P = .019) and between IBP and DCI (r = 0.443 and P = .003) was found.

CONCLUSIONS AND INFERENCES

The Linx procedure had a remarkable effect on esophageal motility in the short-term follow-up. It appears that the overall postoperative increase of IRP and IBP may justify the higher DCI values. Preoperative dysphagia was the only factor associated with postoperative dysphagia.

Authors+Show Affiliations

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

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31633258

Citation

Riva, Carlo Galdino, et al. "High-resolution Manometry Findings After Linx Procedure for Gastro-esophageal Reflux Disease." Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, 2019, pp. e13750.
Riva CG, Siboni S, Sozzi M, et al. High-resolution manometry findings after Linx procedure for gastro-esophageal reflux disease. Neurogastroenterol Motil. 2019.
Riva, C. G., Siboni, S., Sozzi, M., Lazzari, V., Asti, E., & Bonavina, L. (2019). High-resolution manometry findings after Linx procedure for gastro-esophageal reflux disease. Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, pp. e13750. doi:10.1111/nmo.13750.
Riva CG, et al. High-resolution Manometry Findings After Linx Procedure for Gastro-esophageal Reflux Disease. Neurogastroenterol Motil. 2019 Oct 21;e13750. PubMed PMID: 31633258.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High-resolution manometry findings after Linx procedure for gastro-esophageal reflux disease. AU - Riva,Carlo Galdino, AU - Siboni,Stefano, AU - Sozzi,Marco, AU - Lazzari,Veronica, AU - Asti,Emanuele, AU - Bonavina,Luigi, Y1 - 2019/10/21/ PY - 2019/07/29/received PY - 2019/09/13/revised PY - 2019/10/01/accepted PY - 2019/10/22/entrez KW - dysphagia KW - gastro-esophageal reflux disease KW - high-resolution manometry KW - laparoscopic surgery KW - linx procedure KW - magnetic sphincter augmentation SP - e13750 EP - e13750 JF - Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society JO - Neurogastroenterol. Motil. N2 - BACKGROUND: Magnetic sphincter augmentation with the Linx® system is a novel laparoscopic procedure for the treatment of gastro-esophageal reflux disease (GERD). Only few data are available regarding the impact of Linx on high-resolution manometry (HRM) variables. METHODS: The prospectively collected database of patients who underwent Linx procedure at a single institution was queried. All patients who completed pre- and postoperative HRM, GERD health-related quality of life (GERD-HRQL) questionnaire, and functional outcome swallowing scale (FOSS) questionnaire were included in the study. KEY RESULTS: Forty-five out of 304 patients were included. At a median follow-up of 12 months (IQR 10) after surgery, a statistically significant increase of lower esophageal sphincter (LES) total length (P = .002), intra-abdominal length (P = .001), integrated relaxation pressure (IRP), intrabolus pressure (IBP), and esophagogastric contractile integral (EGJ-CI) was noted (P < .001). Distal esophageal amplitude (P = .004), mean distal contractile integral (DCI) (P < .001), post multiple repeated swallows DCI (P = .001), and the percent of normal peristalsis increased (P = .040). All patients were relieved of reflux symptoms. Ineffective esophageal motility reversed to normal in 36% of patients after surgery. The only factor significantly associated with postoperative dysphagia was preoperative dysphagia (P = .006). Postoperatively, a significant correlation between IRP and DCI (r = 0.361 and P = .019) and between IBP and DCI (r = 0.443 and P = .003) was found. CONCLUSIONS AND INFERENCES: The Linx procedure had a remarkable effect on esophageal motility in the short-term follow-up. It appears that the overall postoperative increase of IRP and IBP may justify the higher DCI values. Preoperative dysphagia was the only factor associated with postoperative dysphagia. SN - 1365-2982 UR - https://www.unboundmedicine.com/medline/citation/31633258/High-resolution_manometry_findings_after_Linx_procedure_for_gastro-esophageal_reflux_disease L2 - https://doi.org/10.1111/nmo.13750 DB - PRIME DP - Unbound Medicine ER -