A comparative study of magnetic sphincter augmentation and Nissen fundoplication in the management of GERD

Hernia. 2024 Dec;28(6):2367-2374. doi: 10.1007/s10029-024-03172-z. Epub 2024 Oct 14.

Abstract

Introduction: Magnetic sphincter augmentation (MSA) is a novel surgical technique investigated at many clinical institutes worldwide. In 2012, it received approval for treating Gastroesophageal reflux disease (GERD) because of its superior benefits compared to drug therapies. This study aimed to explore the safety and efficacy of MSA compared with Laparoscopic Nissen fundoplication (LNF) for GERD treatment.

Methods: A retrospective analysis was conducted on 40 patients who received preoperative matching features of MSA and LNF. The surgical details and one-year postoperative outcomes were analyzed and reported.

Results: Significant improvement in GERD symptoms was observed in both MSA and LNF patients over the one-year surgical follow-up. Dysphagia was a common postoperative complication observed in both procedures, but no cases required endoscopic dilation. MSA had a significantly shorter operative time compared to LNF (112 vs.175 min, P < 0.001), with faster postoperative dietary recovery [1(0.5,1.5) vs. 3(1.63,5.38) month(s), P < 0.001] and more preservation of hiccup ability (87.5% vs. 45.83%, P = 0.01). No significant disparities were observed between the two groups regarding hospital duration, recovery of physical strength, and upper gastrointestinal complaints.

Conclusion: In conclusion, both LNF and MSA are safe and successful surgical therapies for GERD. The benefits of MSA include reduced surgical time, quicker nutritional recovery following surgery, and preservation of hiccup capacity. However, with both surgeries, postoperative dysphagia is a prevalent problem that emphasizes the significance of improving preoperative communication. When selecting between two surgical techniques, it is crucial to consider the postoperative symptoms associated with each procedure.

Keywords: Anti-reflux surgery; Gastroesophageal reflux disease; Laparoscopic Nissen fundoplication; Magnetic sphincter augmentation.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Deglutition Disorders / etiology
  • Esophageal Sphincter, Lower / surgery
  • Female
  • Fundoplication* / methods
  • Gastroesophageal Reflux* / surgery
  • Humans
  • Laparoscopy* / methods
  • Magnets
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Treatment Outcome