ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2019
Does Treatment of the Hiatus Influence the Outcomes of Magnetic Sphincter Augmentation for Chronic GERD?
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 19 citations in OpenAlex.
- Long-term (>5 Years) Outcomes after Magnetic Sphincter Augmentation.Annals of surgery · 2026Article
- Longer-term outcomes of gastroesophageal reflux disease treated with magnetic sphincter augmentation.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2023Article
- Safety profile of magnetic sphincter augmentation for gastroesophageal reflux disease.Frontiers in surgery · 2023Article
- Crural closure, not fundoplication, results in a significant decrease in lower esophageal sphincter distensibility.Surgical endoscopy · 2022Article
- Evolution of a novel technology for gastroesophageal reflux disease: a safety perspective of magnetic sphincter augmentation.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2021Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHiatal dissection, restoration of esophageal intra-abdominal length, and crural closure are key components of successful antireflux surgery. The necessity of addressing these components prior to magnetic sphincter augmentation (MSA) has been questioned. We aimed to compare outcomes of MSA between groups with differing hiatal dissection and closure.
methodsWe retrospectively reviewed 259 patients who underwent MSA from 2009 to 2017. Patients were categorized based on hiatal treatment: minimal dissection (MD), crural closure (CC), formal crural repair (FC), and extensive dissection without closure (ED). The primary outcome was normalization of postoperative DeMeester score (≤ 14.72). Univariable and multivariable logistic regression was used to assess which preoperative predictors achieved normalization.
resultsOf the 197 patients, MD was used in 81 (41%); FC in 42 (22%); CC in 40 (20%); and ED in 34 (17%). Normalization occurred in 104 (53%) patients, with MD achieving normalization in 45/81 (56%); FC in 25/42 (60%); CC in 21/40 (53%); and ED 13/34 (38%). After regression, FC was most likely to normalize acid exposure. The presence of a hiatal hernia, defective LES, and higher preoperative DeMeester score were less likely to achieve normalization.
conclusionsHiatal dissection with restoration of esophageal length and crural closure during MSA increases the likelihood of normalizing acid exposure.
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