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Magnetic Sphincter Augmentation for Symptomatic Small Hiatus Hernia

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Abstract

Therapy for gastroesophageal reflux disease and hiatus hernia remains unsatisfactory. About 40% of patients are partial responders to proton-pump inhibitors, and even high dose escalation may be inadequate to maintain in a symptom-free state individuals with a mechanically defective lower esophageal sphincter and volume regurgitation [1]. Furthermore, there are growing concerns over the long-term impact of chronic acid suppression on multiple metabolic and physiologic pathways, and there is evidence that patients suffering from uncontrolled esophageal acid exposure may progress to serious complications of the disease, such as pulmonary aspiration and fibrosis, esophagitis and peptic stricture, and Barrett’s metaplasia, the leading risk factor for esophageal adenocarcinoma [2].

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References

  1. Kahrilas PJ, Howden CW, Hughes N. Response of regurgitation to proton pump inhibitor therapy in clinical trials of gastroesophageal reflux disease. Am J Gastroenterol. 2011;106:1419–25.

    Article  PubMed  Google Scholar 

  2. Malfertheiner P, Nocon M, Vieth M, et al. Evolution of gastro-oesophageal reflux disease over 5 years under routine medical care – the ProGERD study. Aliment Pharmacol Ther. 2012;35:154–64.

    Article  CAS  PubMed  Google Scholar 

  3. Galmiche JP, Hatlebakk J, Attwood S, et al. Laparoscopic antireflux surgery vs esomeprazole treatment for chronic GERD: the LOTUS randomized clinical trial. JAMA. 2011;305(19):1969–77.

    Article  CAS  PubMed  Google Scholar 

  4. Richter JE, Dempsey DT. Laparoscopic antireflux surgery: key to success in the community setting. Am J Gastroenterol. 2008;103:289–91.

    Article  PubMed  Google Scholar 

  5. Khan F, Maradey-Romero C, Ganocy S, Frazier R, Fass R. Utilisation of surgical fundoplication for patients with gastro-oesophageal reflux disease in the USA has declined rapidly between 2009 and 2013. Aliment Pharmacol Ther. 2016;43:1124–31.

    Article  CAS  PubMed  Google Scholar 

  6. Bonavina L, Saino G, Bona D, et al. Magnetic augmentation of the lower esophageal sphincter: results of a feasibility clinical trial. J Gastrointest Surg. 2008;12:2133–40.

    Article  PubMed  Google Scholar 

  7. Bonavina L, DeMeester TR, Fockens P, et al. Laparoscopic sphincter augmentation device eliminates reflux symptoms and normalizes esophageal acid exposure. Ann Surg. 2010;252:857–62.

    Article  PubMed  Google Scholar 

  8. Lipham JC, DeMeester TR, Ganz RA, et al. The Linx reflux management system: confirmed safety and efficacy now at 4 years. Surg Endosc. 2012;26:2944–9.

    Article  PubMed  Google Scholar 

  9. Saino G, Bonavina L, Lipham J, Dunn D, Ganz RA. Magnetic sphincter augmentation for gastroesophageal reflux at 5 years: final results of a pilot study show long-term acid reduction and symptom improvement. J Laparoendosc Adv Surg Tech A. 2015;25:787–92.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Ganz RA, Peters JH, Horgan S, et al. Esophageal sphincter device for gastroesophageal reflux disease. N Engl J Med. 2013;368:719–27.

    Article  CAS  PubMed  Google Scholar 

  11. Bonavina L, Saino G, Bona D, et al. One hundred consecutive patients treated with magnetic sphincter augmentation for gastroesophageal reflux disease: 6 years of clinical experience from a single center. J Am Coll Surg. 2013;217:577–85.

    Article  PubMed  Google Scholar 

  12. Smith CD, Devault KR, Buchanan M. Introduction of mechanical sphincter augmentation for gastroesophageal reflux disease into practice: early clinical outcomes and keys to successful adoption. J Am Coll Surg. 2014;218:776–81.

    Article  PubMed  Google Scholar 

  13. Louie BE, Farivar AS, Schultz D, et al. Short-term outcomes using magnetic sphincter augmentation versus Nissen fundoplication for medically resistant gastroesophageal reflux disease. Ann Thorac Surg. 2014;98:498–504.

    Article  PubMed  Google Scholar 

  14. Riegler M, Schoppman SF, Bonavina L, et al. Magnetic sphincter augmentation and fundoplication for GERD in clinical practice: one-year results of a multicenter, prospective observational study. Surg Endosc. 2015;29:1123–9.

    Article  PubMed  Google Scholar 

  15. Reynolds J, Zehetner J, Wu P, et al. Laparoscopic magnetic sphincter augmentation vs laparoscopic Nissen fundoplication; a matched-pair analysis of 100 patients. Ann Surg. 2015;221:123–8.

    Google Scholar 

  16. Lipham JC, Taiganides PA, Louie BE, et al. Safety analysis of first 1000 patients treated with magnetic sphincter augmentation for gastroesophageal reflux disease. Dis Esophagus. 2015;28:305–11.

    Article  CAS  PubMed  Google Scholar 

  17. Ganz RA, Edmundowicz SA, Taiganides PA, et al. Long-term outcomes of patients receiving a magnetic sphincter augmentation device for gastroesophageal reflux. Clin Gastroenterol Hepatol. 2016;14:671–7.

    Article  PubMed  Google Scholar 

  18. Asti E, Siboni S, Lazzari V, et al. Removal of the magnetic sphincter device. Surgical technique and results of a single-center cohort study. Ann Surg. 2017;265(5):941–5. PMID:27163959.

    Article  PubMed  Google Scholar 

  19. Rona KA, Reynolds J, Schwameis K, et al. Efficacy of magnetic sphincter augmentation in patients with large hiatal hernias. Surg Endosc. 2017;31(5):2096–102. PMID:27553803.

    Article  PubMed  Google Scholar 

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Correspondence to Luigi Bonavina .

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Bonavina, L., Sironi, A., Asti, E. (2018). Magnetic Sphincter Augmentation for Symptomatic Small Hiatus Hernia. In: Memon, M. (eds) Hiatal Hernia Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-64003-7_8

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  • DOI: https://doi.org/10.1007/978-3-319-64003-7_8

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  • Online ISBN: 978-3-319-64003-7

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