University of Southern California, Surgery.
USC Keck School of Medicine, Upper GI & General Surgery.
Dis Esophagus. 2023 Jun 15;36(Supplement_1). doi: 10.1093/dote/doac080.
Gastroesophageal reflux disease (GERD)-the pathologic reflux of gastric contents into the distal esophagus-is the most common benign disorder of the esophagus. Its incidence is at 10-20% of the Western population and it yearly cost of treatment in the USA in 9.3 billion dollars. Although first line treatment for the disorder is medical therapy with proton pump inhibitors, an estimated 30-40% of patients will continue to experience medically refractory GERD. In this population anti-reflux surgery can be offered. Traditional anti-reflux surgery is done via the Nissen fundoplication, a technically difficult surgery with uncomfortable side effects of bloating and inability to belch. Magnetic sphincter augmentation (MSA) of the lower esophagus via the LINX device was introduced a less technically challenging alternative to the Nissen. The LINX provides fewer side effects of bloating and inability to belch and has been adapted widely to the practice of anti-reflux surgery. In this paper we discuss the progression of surgical practices with the LINX, including an analysis of the laparoscopic and robotic approaches to MSA device implantation.
胃食管反流病（GERD）-胃内容物病理性反流至远端食管-是最常见的食管良性疾病。其在西方人群中的发病率为 10-20%，在美国的年治疗费用为 93 亿美元。尽管该疾病的一线治疗是质子泵抑制剂的药物治疗，但估计有 30-40%的患者将继续经历药物难治性 GERD。在这种情况下，可以提供抗反流手术。传统的抗反流手术是通过 Nissen 胃底折叠术进行的，这是一种技术难度较大的手术，会产生腹胀和呃逆困难等不适副作用。通过 LINX 装置对食管下段进行磁括约肌增强（MSA）是一种技术难度较小的替代 Nissen 手术的方法。LINX 减少了腹胀和呃逆困难等副作用，并已广泛应用于抗反流手术实践中。在本文中，我们讨论了 LINX 的手术实践进展，包括对 MSA 装置植入的腹腔镜和机器人方法的分析。
