Open AccessSevere Dysphagia is Rare After Magnetic Sphincter Augmentation
Author(s) -
Bologheanu Milena,
Matic Aleksa,
Feka Joy,
Asari Reza,
Bologheanu Razvan,
Riegler Franz M.,
Gensthaler Lisa,
Osmokrovic Bogdan,
Schoppmann Sebastian F.
Publication year - 2022
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-022-06573-2
Subject(s) - medicine , dysphagia , vascular surgery , cardiac surgery , cardiothoracic surgery , abdominal surgery , surgery , sphincter , general surgery , radiology
Background Dysphagia remains the most significant concern after anti‐reflux surgery, including magnetic sphincter augmentation (MSA). The aim of this study was to evaluate postoperative dysphagia rates, its risk factors, and management after MSA. Methods From a prospectively collected database of all 357 patients that underwent MSA at our institution, a total of 268 patients were included in our retrospective study. Postoperative dysphagia score, gastrointestinal symptoms, proton pump inhibitor intake, GERD‐HRQL, Alimentary Satisfaction, and serial contrast swallow imaging were evaluated within standardized follow‐up appointments. To determine patients’ characteristics and surgical factors associated with postoperative dysphagia, a multivariable logistic regression analysis was performed. Results At a median follow‐up of 23 months, none of the patients presented with severe dysphagia, defined as the inability to swallow solids or/and liquids. 1% of the patients underwent endoscopic dilatation, and 1% had been treated conservatively for dysphagia. 2% of the patients needed re‐operation, most commonly due to recurrent hiatal hernia. Two patients underwent device removal due to unspecific discomfort and pain. No migration of the device or erosion by the device was seen. The LINX® device size ≤ 13 was found to be the only factor associated with postoperative dysphagia (OR 5.90 (95% CI 1.4–24.8)). The postoperative total GERD‐HRQL score was significantly lower than preoperative total score (2 vs. 19; p = 0.001), and daily heartburn, regurgitations, and respiratory complains improved in 228/241 (95%), 131/138 (95%) and 92/97 (95%) of patients, respectively. Conclusions Dysphagia requiring endoscopic or surgical intervention was rare after MSA in a large case series. LINX® devices with a size < 13 were shown to be an independent risk factor for developing postoperative dysphagia.