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S148: Long-term patient-reported outcomes of laparoscopic magnetic sphincter augmentation versus Nissen fundoplication: a 5-year follow-up study

  • 2021 SAGES Oral
  • Published:
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Abstract

Background

Laparoscopic magnetic sphincter augmentation (MSA) has emerged as an alternative to laparoscopic Nissen fundoplication (LNF) for the management of symptomatic gastroesophageal reflux disease (GERD). While short-term outcomes of MSA compare favorably to those of LNF, direct comparisons of long-term outcomes are lacking. We hypothesized that the long-term patient-reported outcomes of MSA would be similar to those achieved with LNF.

Methods

We tested this hypothesis in a retrospective cohort undergoing primary LNF or MSA between March 2013 and July 2015. The primary outcome was GERD-Health Related Quality of Life (GERD-HRQL) score at long-term follow-up relative to baseline. Secondary outcomes included dysphagia and bloating scores, proton-pump inhibitor (PPI) cessation, reoperations, and overall satisfaction with surgery.

Results

70 patients (25 MSA, 45 LNF) met criteria for study inclusion. MSA patients had lower baseline BMI (median: 27.1 [IQR: 22.7–29.9] versus 30.4 [26.4–32.8], p = 0.02), lower total GERD-HRQL (26 [19–32] versus 34 [25–40], p = 0.02), and dysphagia (2 [0–3] versus 3 [1–4], p = 0.02) scores. Median follow-up interval exceeded 5 years (MSA: 68 [65–74]; LNF: 65 months [62–69]). Total GERD-HRQL improved from 26 to 9 after MSA (p < 0.001) and from 34 to 7.5 after LNF (p < 0.01); these scores did not differ between groups (p = 0.68). Dysphagia (MSA: 1 [0–2]; LNF: 0 [0–2], p = 0.96) and bloating (MSA: 1.5 [0.5–3.0]; LNF: 3.0 [1.0–4.0], p = 0.08) scores did not show any statistically significant differences. Device removal was performed in 4 (16%) MSA patients and reoperation in 3 (7%) LNF patients. Eighty-nine percent of LNF patients reported satisfaction with the procedure, compared to 70% of MSA patients (p = 0.09).

Conclusions

MSA appears to offer similar long-term improvement in disease-specific quality of life as LNF. For MSA, there was a trend toward reduced long-term bloating compared to LNF, but need for reoperation and device removal may be associated with patient dissatisfaction.

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Authors and Affiliations

  1. Division of Minimally Invasive Surgery, University of Michigan, Ann Arbor, MI, USA

    Sean M. O’Neill

  2. Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Anahita D. Jalilvand

  3. Department of Surgery, University of Cincinnati, Cincinnati, OH, USA

    Jennifer S. Colvin

  4. Center for Minimally Invasive Surgery, The Ohio State University Wexner Medical Center, N729 Doan Hall, 410 W 10th Ave, Columbus, OH, USA

    Kelly R. Haisley & Kyle A. Perry

Authors
  1. Sean M. O’Neill
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  2. Anahita D. Jalilvand
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  3. Jennifer S. Colvin
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  4. Kelly R. Haisley
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  5. Kyle A. Perry
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Correspondence to Kyle A. Perry.

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Drs. O’Neill, Jalilvand, Colvin, Haisley, and Perry have no conflicts of interest or financial ties to disclose.

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O’Neill, S.M., Jalilvand, A.D., Colvin, J.S. et al. S148: Long-term patient-reported outcomes of laparoscopic magnetic sphincter augmentation versus Nissen fundoplication: a 5-year follow-up study. Surg Endosc 36, 6851–6858 (2022). https://doi.org/10.1007/s00464-022-09015-1

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  • DOI: https://doi.org/10.1007/s00464-022-09015-1

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