Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Department of Trauma Surgery, Krankenhaus Oberwart, Dornburggasse 80, 7400, Oberwart, Austria.
J Gastrointest Surg. 2022 Mar;26(3):532-541. doi: 10.1007/s11605-021-05152-5. Epub 2021 Sep 29.
Magnetic sphincter augmentation (MSA) is a modern surgical anti-reflux technique with proven efficacy and low postoperative morbidity in patients with acidic reflux. The aim of this retrospective review study was to evaluate the symptomatic outcome of MSA in patients with weakly acidic reflux.
From a prospectively collected clinical database, comprising all 327 patients that underwent MSA at our institution, a total of 67 patients with preoperative weakly acidic reflux measured in the 24-h impedance-pH-metry were identified. Postoperative gastrointestinal symptoms, proton pump inhibitor intake (PPI), GERD Health-Related Quality-of-Life (GERD-HRQL), alimentary satisfaction (AS), and patients' overall satisfaction were evaluated within highly standardized follow-up appointments. Furthermore, outcome of these patients was compared to the postoperative outcome of a comparable group of patients with a preoperative acidic reflux.
At a median follow-up of 24 months, none of the patients with weakly acidic reflux presented with persistent dysphagia, or underwent endoscopic dilatation or reoperation. The postoperative GERD-HRQL score was significantly reduced (2 vs. 20; p = 0.001) and the median AS was 9/10. Preoperative daily heartburn, regurgitations, and respiratory complaints were improved in 95%, 95%, and 96% of patients, respectively. A total of 10% of the patients continued to use PPIs postoperatively. No significant difference was observed in terms of postoperative outcome or quality of life when comparing weakly acidic reflux patients with those diagnosed with preoperative acidic reflux.
Magnetic sphincter augmentation significantly improves GERD-related symptoms and quality of life in patients with weakly acidic reflux with very low postoperative morbidity.
磁括约肌增强术（MSA）是一种现代的外科抗反流技术，已被证实对酸性反流患者具有疗效，且术后发病率低。本回顾性研究旨在评估 MSA 对弱酸性反流患者的症状改善效果。
从我们机构前瞻性收集的临床数据库中，共纳入 327 例接受 MSA 的患者，其中有 67 例患者术前 24 小时阻抗-pH 监测显示存在弱酸性反流。通过高度标准化的随访评估，评估术后胃肠道症状、质子泵抑制剂（PPI）摄入、胃食管反流病健康相关生活质量（GERD-HRQL）、进食满意度（AS）以及患者的整体满意度。此外，将这些患者的术后结果与术前存在酸性反流的可比患者的术后结果进行比较。
在中位随访 24 个月时，没有弱酸性反流患者出现持续性吞咽困难，也没有进行内镜扩张或再次手术。术后 GERD-HRQL 评分显著降低（2 分 vs. 20 分；p = 0.001），AS 中位数为 9/10。95%的患者术后每日烧心、反流和呼吸症状得到改善，分别有 95%、95%和 96%的患者得到改善。术后有 10%的患者继续使用 PPI。与术前诊断为酸性反流的患者相比，弱酸性反流患者的术后结果或生活质量没有显著差异。
磁括约肌增强术可显著改善弱酸性反流患者的 GERD 相关症状和生活质量，且术后发病率低。
