Steven G Leeds1,2,3, Andrew Ngov4,5, Gerald O Ogola5, Marc A Ward6,4,7. 1. Center for Advanced Surgery, Baylor Scott and White Health, Dallas, TX, USA. Steven.Leeds@BSWHealth.org. 2. Department of Minimally Invasive Surgery, Baylor University Medical Center, 3417 Gaston Avenue, Suite 1000 East, Dallas, TX, 75246, USA. Steven.Leeds@BSWHealth.org. 3. Texas A&M University College of Medicine, Bryan, TX, USA. Steven.Leeds@BSWHealth.org. 4. Department of Minimally Invasive Surgery, Baylor University Medical Center, 3417 Gaston Avenue, Suite 1000 East, Dallas, TX, 75246, USA. 5. Baylor Scott & White Research Institute, Dallas, TX, USA. 6. Center for Advanced Surgery, Baylor Scott and White Health, Dallas, TX, USA. 7. Texas A&M University College of Medicine, Bryan, TX, USA.
Abstract
BACKGROUND: Magnetic sphincter augmentation (MSA) has been recognized as an effective treatment option for patients with gastroesophageal reflux disease. The feasibility of MSA in patients with prior gastric surgery has not been well established. This study aims to evaluate the safety and efficacy of MSA in patients with prior gastric surgery including bariatric and other anti-reflux operations. METHODS: A prospectively gathered registry approved by the institutional review board for patients undergoing anti-reflux surgery was retrospectively reviewed. All patients who underwent MSA were included. The patients were divided into two groups based on the presence of prior gastric surgeries compared to those without. Endpoints collected include differences between the two groups in their preoperative evaluation, perioperative course, and postoperative effectiveness. RESULTS: A total of 103 patients underwent MSA where 82 patients (80%) had no prior gastric surgery and 21 patients (20%) had prior gastric surgery. The prior gastric surgery group included 10 patients with prior anti-reflux surgery, 11 patients with prior bariatric surgery. Perioperative factors were higher in the prior gastric surgery group including operating room time (135 min vs. 93 min, p = < 0.001), number of beads used (16 vs. 14, p = < 0.001), and percent of patients staying overnight (47% vs. 5%, p = < 0.001). There was no difference in several factors of their preoperative evaluation including preoperative GERD-HRQL and RSI scores, hiatal hernia presence, or DeMeester score. Post-operative GERD-HRQL and RSI scores were not different as well as patient satisfaction, patients resuming PPI use, and device explant rate. CONCLUSIONS: This study demonstrates equivalent outcomes with integration of MSA in patients with prior gastric surgery in comparison to patients without prior gastric surgery. However, these surgeries are longer, require larger devices, and patients are more likely to stay overnight.
BACKGROUND: Magnetic sphincter augmentation (MSA) has been recognized as an effective treatment option for patients with gastroesophageal reflux disease. The feasibility of MSA in patients with prior gastric surgery has not been well established. This study aims to evaluate the safety and efficacy of MSA in patients with prior gastric surgery including bariatric and other anti-reflux operations. METHODS: A prospectively gathered registry approved by the institutional review board for patients undergoing anti-reflux surgery was retrospectively reviewed. All patients who underwent MSA were included. The patients were divided into two groups based on the presence of prior gastric surgeries compared to those without. Endpoints collected include differences between the two groups in their preoperative evaluation, perioperative course, and postoperative effectiveness. RESULTS: A total of 103 patients underwent MSA where 82 patients (80%) had no prior gastric surgery and 21 patients (20%) had prior gastric surgery. The prior gastric surgery group included 10 patients with prior anti-reflux surgery, 11 patients with prior bariatric surgery. Perioperative factors were higher in the prior gastric surgery group including operating room time (135 min vs. 93 min, p = < 0.001), number of beads used (16 vs. 14, p = < 0.001), and percent of patients staying overnight (47% vs. 5%, p = < 0.001). There was no difference in several factors of their preoperative evaluation including preoperative GERD-HRQL and RSI scores, hiatal hernia presence, or DeMeester score. Post-operative GERD-HRQL and RSI scores were not different as well as patient satisfaction, patients resuming PPI use, and device explant rate. CONCLUSIONS: This study demonstrates equivalent outcomes with integration of MSA in patients with prior gastric surgery in comparison to patients without prior gastric surgery. However, these surgeries are longer, require larger devices, and patients are more likely to stay overnight.
Authors: Marc A Ward; Ahmed Ebrahim; Jeffrey Kopita; Lindsay Arviso; Gerald O Ogola; Brittany Buckmaster; Steven G Leeds Journal: Surg Endosc Date: 2019-12-02 Impact factor: 4.584
Authors: Ozanan R Meireles; Guy Rosman; Maria S Altieri; Lawrence Carin; Gregory Hager; Amin Madani; Nicolas Padoy; Carla M Pugh; Patricia Sylla; Thomas M Ward; Daniel A Hashimoto Journal: Surg Endosc Date: 2021-07-06 Impact factor: 4.584