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Revaluation of the efficacy of magnetic sphincter augmentation for treating gastroesophageal reflux disease

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Abstract

Background

Gastroesophageal reflux disease (GERD) is a prevalent disease which severely impacts the quality of life of the patients. The surgical options are limited to such patients who are not satisfied with medical therapies. Magnetic sphincter augmentation (MSA) is a new antireflux surgical technique for treating GERD, which could physiologically reinforce the lower esophageal sphincter by magnetic force. Many clinical and animal studies have focused on this new therapy. The purpose of this work was to review the feasibility, efficacy and safety of MSA as a new treatment for GERD.

Methods

We performed a PubMed database search for the MSA and GERD-related studies between 2008 and September 22, 2015. One animal study, two case reports and fifteen clinical studies were identified in this review.

Results

The MSA device reinforces the lower esophageal sphincter to antireflux via magnetic force. The feasibility of this laparoscopic technique has been proved by the experimental and clinical studies. The clinical studies demonstrate that MSA treatment could effectively reduce the percent time of esophageal acid exposure (pH < 4) and improve the GERD health-related quality of life score. The operation time of MSA is shorter than that of the Nissen fundoplication, and the efficacy of MSA treatment is equal to that of fundoplication. The most frequent postoperative complication is dysphagia, and the majority of them could be self-resolved with conservative treatment.

Conclusion

MSA (or LINX) devices provide an alternative surgical option for the patients who had failed in medical therapy. This review of the current literatures demonstrates that MSA is as effective as the medical and conventional surgical therapies. In the future, MSA will play a more important role in the treatment of GERD because of its unique advantage.

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Acknowledgments

This work was supported by the Special Fund for Basic Research on Scientific Instruments of the National Natural Science Foundation of China (Grant No. 81127005/H0322).

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery, First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, 710061, People’s Republic of China

    Hongke Zhang, Dinghui Dong, Liangshuo Hu & Yi Lv

  2. Research Institute of Advanced Surgical Techniques and Engineering, Xi’an Jiaotong University, Xi’an, People’s Republic of China

    Zhengwen Liu

  3. Department of Gastroenterology, First Affiliated Hospital, Xi’an Jiaotong University, Xi’an, People’s Republic of China

    Shuixiang He

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  1. Hongke Zhang
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  2. Dinghui Dong
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  3. Zhengwen Liu
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  5. Liangshuo Hu
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  6. Yi Lv
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Correspondence to Yi Lv.

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Disclosures

Dr. Lv received grants from National Natural Science Foundation of China, during the conduct of this work. Hongke Zhang, Dinghui Dong, Zhengwen Liu, Shuixiang He and Liangshuo Hu have no conflicts of interest to disclose.

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Zhang, H., Dong, D., Liu, Z. et al. Revaluation of the efficacy of magnetic sphincter augmentation for treating gastroesophageal reflux disease. Surg Endosc 30, 3684–3690 (2016). https://doi.org/10.1007/s00464-015-4701-0

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  • DOI: https://doi.org/10.1007/s00464-015-4701-0

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