PMID- 31069388
OWN - NLM
STAT- MEDLINE
DCOM- 20200414
LR  - 20200414
IS  - 1442-2050 (Electronic)
IS  - 1120-8694 (Linking)
VI  - 32
IP  - 9
DP  - 2019 Nov 13
TI  - Laparoscopic magnetic sphincter augmentation versus fundoplication for 
      gastroesophageal reflux disease: systematic review and pooled analysis.
LID - doz031 [pii]
LID - 10.1093/dote/doz031 [doi]
AB  - Magnetic sphincter augmentation (MSA) has been proposed as a less invasive, more 
      appealing alternative intervention to fundoplication for the treatment of 
      gastroesophageal reflux disease (GERD). The aim of this study was to evaluate 
      clinical outcomes following MSA for GERD control in comparison with laparoscopic 
      fundoplication. A systematic electronic search for articles was performed in 
      Medline, Embase, Web of Science, and Cochrane Library for single-arm cohort 
      studies or comparative studies (with fundoplication) evaluating the use of MSA. A 
      random-effects meta-analysis for postoperative proton pump inhibitor (PPI) use, 
      GERD-health-related quality of life (GERD-HRQOL), gas bloating, ability to belch, 
      dysphagia, and reoperation was performed. The systematic review identified 6 
      comparative studies of MSA versus fundoplication and 13 single-cohort studies. 
      Following MSA, only 13.2% required postoperative PPI therapy, 7.8% dilatation, 
      3.3% device removal or reoperation, and esophageal erosion was seen in 0.3%. 
      There was no significant difference between the groups in requirement for 
      postoperative PPI therapy (pooled odds ratio, POR = 1.08; 95%CI 0.40-2.95), 
      GERD-HRQOL score (weighted mean difference, WMD = 0.34; 95%CI -0.70-1.37), 
      dysphagia (POR = 0.94; 95%CI 0.57-1.55), and reoperation (POR = 1.23; 95%CI 
      0.26-5.8). However, when compared to fundoplication MSA was associated with 
      significantly less gas bloating (POR = 0.34; 95%CI 0.16-0.71) and a greater 
      ability to belch (POR = 12.34; 95%CI 6.43-23.7). In conclusion, magnetic 
      sphincter augmentation achieves good GERD symptomatic control similar to that of 
      fundoplication, with the benefit of less gas bloating. The safety of MSA also 
      appears acceptable with only 3.3% of patients requiring device removal. There is 
      an urgent need for randomized data directly comparing fundoplication with MSA for 
      the treatment of GERD to truly evaluate the efficacy of this treatment approach.
CI  - (c) The Author(s) 2019. Published by Oxford University Press on behalf of 
      International Society for Diseases of the Esophagus. All rights reserved. For 
      permissions, please e-mail: journals.permissions@oup.com.
FAU - Guidozzi, Nadia
AU  - Guidozzi N
AD  - Department of Surgery and Cancer, Imperial College London, United Kingdom.
FAU - Wiggins, Tom
AU  - Wiggins T
AD  - Department of Surgery and Cancer, Imperial College London, United Kingdom.
FAU - Ahmed, Ahmed R
AU  - Ahmed AR
AD  - Department of Surgery and Cancer, Imperial College London, United Kingdom.
FAU - Hanna, George B
AU  - Hanna GB
AD  - Department of Surgery and Cancer, Imperial College London, United Kingdom.
FAU - Markar, Sheraz R
AU  - Markar SR
AD  - Department of Surgery and Cancer, Imperial College London, United Kingdom.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - United States
TA  - Dis Esophagus
JT  - Diseases of the esophagus : official journal of the International Society for 
      Diseases of the Esophagus
JID - 8809160
SB  - IM
MH  - Esophageal Sphincter, Lower/diagnostic imaging/*surgery
MH  - *Fundoplication
MH  - Gastroesophageal Reflux/diagnostic imaging/*surgery
MH  - Humans
MH  - Laparoscopy/instrumentation/*methods
MH  - *Magnets
MH  - Treatment Outcome
OTO - NOTNLM
OT  - fundoplication
OT  - gastroesophageal reflux disease
OT  - magnetic sphincter augmentation
EDAT- 2019/05/10 06:00
MHDA- 2020/04/15 06:00
CRDT- 2019/05/10 06:00
PHST- 2019/01/20 00:00 [received]
PHST- 2019/02/27 00:00 [revised]
PHST- 2019/05/10 06:00 [pubmed]
PHST- 2020/04/15 06:00 [medline]
PHST- 2019/05/10 06:00 [entrez]
AID - 5487251 [pii]
AID - 10.1093/dote/doz031 [doi]
PST - ppublish
SO  - Dis Esophagus. 2019 Nov 13;32(9):doz031. doi: 10.1093/dote/doz031.