PMID- 27472725
OWN - NLM
STAT- MEDLINE
DCOM- 20170214
LR  - 20220321
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 95
IP  - 30
DP  - 2016 Jul
TI  - Longitudinal comparison of quality of life in patients undergoing laparoscopic 
      Toupet fundoplication versus magnetic sphincter augmentation: Observational 
      cohort study with propensity score analysis.
PG  - e4366
LID - 10.1097/MD.0000000000004366 [doi]
LID - e4366
AB  - Only a minority of patients with gastro-esophageal reflux disease (GERD) are 
      offered a surgical option. This is mostly due to the fear of potential side 
      effects, the variable success rate, and the extreme alteration of gastric anatomy 
      with the current gold standard, the laparoscopic Nissen fundoplication. It has 
      been reported that laparoscopic Toupet fundoplication (LTF) and laparoscopic 
      sphincter augmentation using a magnetic device (LINX) can treat reflux more 
      physiologically and with a lower incidence of side-effects and reoperation rate. 
      We present the first comparing quality of life in patients undergoing LTF versus 
      LINX.Observational cohort study. Consecutive patients undergoing LTF or LINX over 
      the same time period were compared by using the propensity score full matching 
      method and generalized estimating equation. Criteria of exclusion were >3 cm 
      hiatal hernia, grade C-D esophagitis, ineffective esophageal motility, body mass 
      index >35, and previous upper abdominal surgery. The primary study outcome was 
      quality of life measured with the Gastro-Esophageal Reflux Disease-Health Related 
      Quality of Life (GERD-HRQL) questionnaire. Secondary outcomes were proton pump 
      inhibitors (PPI) use, presence of gas-related symptoms or dysphagia, and 
      reoperation-free probability.Between March 2007 and July 2014, 238 patients with 
      GERD met the criteria of inclusion in the study. Of these, 103 underwent an LTF 
      and 135 a LINX procedure. All patients had a minimum 1-year follow-up. Over time, 
      patients in both groups had similar GERD-HRQL scores (odds ratio [OR] 1.04, 
      confidence interval [CI] 0.89-1.27; P = 0.578), PPI use (OR 1.18, CI 0.81-1.70; 
      P = 0.388), gas-related symptoms (OR 0.69, CI 0.21-2.28; P = 0.542), dysphagia 
      (OR 0.62, CI 0.26-1.30; P = 0.241), and reoperation-free probability (stratified 
      log-rank test = 0.556).In 2 concurrent cohorts of patients with early stage GERD 
      undergoing LTF or LINX and matched by propensity score analysis, health-related 
      quality of life significantly improved and GERD-HRQL scores had a similar 
      decreasing trend over time up to 7 years of follow-up. We conclude that LTF and 
      LINX provide similar disease-specific quality of life over time in patients with 
      early stage GERD.
FAU - Asti, Emanuele
AU  - Asti E
AD  - Department of Biomedical Sciences for Health, Division of General Surgery, 
      University of Milan Medical School, IRCCS Policlinico San Donato, San Donato 
      Milanese, Milan, Italy.
FAU - Bonitta, Gianluca
AU  - Bonitta G
FAU - Lovece, Andrea
AU  - Lovece A
FAU - Lazzari, Veronica
AU  - Lazzari V
FAU - Bonavina, Luigi
AU  - Bonavina L
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cohort Studies
MH  - Esophagogastric Junction/*surgery
MH  - Female
MH  - Fundoplication/*methods/*psychology
MH  - Gastroesophageal Reflux/*surgery
MH  - Humans
MH  - Laparoscopy/*methods/*psychology
MH  - Longitudinal Studies
MH  - *Magnets
MH  - Male
MH  - Middle Aged
MH  - Operative Time
MH  - Postoperative Complications/*psychology
MH  - *Propensity Score
MH  - *Prostheses and Implants
MH  - Quality of Life/*psychology
MH  - Surveys and Questionnaires
PMC - PMC5265862
COIS- The authors have no funding and conflicts of interest to disclose.
EDAT- 2016/07/30 06:00
MHDA- 2017/02/15 06:00
PMCR- 2016/07/29
CRDT- 2016/07/30 06:00
PHST- 2016/07/30 06:00 [entrez]
PHST- 2016/07/30 06:00 [pubmed]
PHST- 2017/02/15 06:00 [medline]
PHST- 2016/07/29 00:00 [pmc-release]
AID - 00005792-201607260-00061 [pii]
AID - 10.1097/MD.0000000000004366 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2016 Jul;95(30):e4366. doi: 10.1097/MD.0000000000004366.