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Update in Procedural Therapy for GERD – Magnetic Sphincter Augmentation, Endoscopic Transoral Incisionless Fundoplication vs Laparoscopic Nissen Fundoplication

  • Esophagus (L Gerson, Section Editor)
  • Published:
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Abstract

Gastroesophageal reflux disease (GERD) is a common and progressive condition manifested by heartburn or regurgitation. Though Nissen fundoplication has been and remains the gold standard for procedural therapy for GERD, two newer interventions have gained popularity: magnetic sphincter augmentation (MSA), which entails the placement of a self expanding magnetic ring around the gastroesophageal (GE) junction, and transoral incisionless fundoplication (TIF), an endoscopic approach that creates a neogastroesophageal valve near the fundus. Collective data gathered from four studies published within the past year suggest that the three modalities share comparable effectiveness in pH monitoring and patient satisfaction, TIF may have a lower proton pump inhibitor cessation rate, and Nissen fundoplication required longer recovery time and had a more serious adverse effects profile. Large, prospective, randomized controlled studies are needed to reliably compare the three procedures.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Kahrilas PJ. Gastroesophageal reflux disease. N Engl J Med. 2008;359:1700–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Katz PO, Zavala S. Proton pump inhibitors in the management of GERD. J Gastrointest Surg. 2010;14 Suppl 1:S62–6.

    Article  PubMed  Google Scholar 

  3. Castell DO, Kahrilas PJ, Richter JE, et al. Esomeprazole (40 mg) Compared with Lansoprazole (30 mg) in the Treatment of Erosive Esophagitis. Am J Gastroenterol. 2002;97:575–83.

    Article  CAS  PubMed  Google Scholar 

  4. Finks JF, Wei Y, Brinkmeyer JD. The rise and fall of anti-reflux surgery in the United States. Surg Endosc. 2006;20:1698–701.

    Article  PubMed  Google Scholar 

  5. Wang YR, Dempsey DT, Richter JE. Trends and perioperative outcomes of inpatient anti-reflux surgery in the United States, 1993-2006. Dis Esophagus. 2011;24:215–23.

    Article  CAS  PubMed  Google Scholar 

  6. Nissen R. Eine einfache operation zur beeinflussung der refluxoesophagitis. Schweiz Med Wochenschr. 1956;86:590–2.

    CAS  PubMed  Google Scholar 

  7. Dallemagne B, Weerts JM, Jehaes C, Markiewicz S, Lombard R. Laparoscopic Nissen Fundoplication: preliminary report. Surg Endosc. 1991;3:138–43.

    Google Scholar 

  8. Broeders JA, Rijnhart-de Jong HG, Draaisma WA, et al. Ten-year outcome of laparoscopic and conventional Nissen Fundoplication: randomized clinical trial. Ann Surg. 2009;250:698–706.

    Article  PubMed  Google Scholar 

  9. Peters JH, Heimbucher J, Kauer WK, et al. Clinical and physiologic comparison of laparoscopic and open Nissen fundoplication. J Am Coll Surg. 1995;180:385.

    CAS  PubMed  Google Scholar 

  10. Herron DM, Swanström LL, Ramzi N, Hansen PD. Factors predictive of dysphagia after laparoscopic Nissen fundoplication. Surg Endosc. 1999;13:1180.

    Article  CAS  PubMed  Google Scholar 

  11. Granderath FA, Kamolz T, Granderath UM, Pointner R. Gas-related symptoms after laparoscopic 360 degrees Nissen or 270 degrees Toupet fundoplication in gastrooesophageal reflux disease patients with aerophagia as comorbidity. Dig Liver Dis. 2007;39:312.

    Article  CAS  PubMed  Google Scholar 

  12. Stefanidis D, Hope WW, Kohn GP, et al. Guidelines for surgical treatment of gatroensophageal reflux disease. Surg Endosc. 2010;24:2647–69.

    Article  PubMed  Google Scholar 

  13. Falk GW, Fennerty MB, Rothstein RI. AGA Institute Technical Review on the use of Endoscopic Therapy for Gastroesophageal Reflux Disease. Gastroenterology. 2006;131:1315–36.

    Article  PubMed  Google Scholar 

  14. Testoni PA, Vailati C, Testoni S, et al. Transoral Incisionless Fundoplication (TIF 2.0) with esophyX for gastroesophageal reflux disease: long-term results and findings affecting outcome. Surg Endosc. 2012;26:1425–35.

    Article  PubMed  Google Scholar 

  15. • Ganz GA, Peters JH, Horgan S, et al. Esophageal sphincter device for gastroesophageal reflux disease. N Eng J Med. 2013;368(8):719–27. This paper provides a thorough description of magnetic sphincter augmentation and contains both objective and subjective clinical outcomes of 100 prospectively assessed patients at 3 years post implementation.

  16. DeMeester TR, Bonavina L, Albertucci M. Nissen fundoplication for gastroesophageal reflux disease. Ann Surg. 1986;204:9–20.

    Article  CAS  PubMed  Google Scholar 

  17. Cai W, Watson DI, Lally CJ, et al. Ten-year clinical outcome of a prospective randomized clinical trial of laparoscopic NIssen vs anterior 180 degrees partial fundoplication. Br J Surg. 2008;95:1501–5.

    Article  CAS  PubMed  Google Scholar 

  18. • Kellokumpu I, Voutilainen V, Haglund C, et al. Quality of life following laprascopic Nissen fundoplication: assessing short-term and long-term outcome. World J Gastroenterol. 2013;19(24):3810–8. This paper contains subjective, objective, and adverse effects data on Nissen fundoplication collected at different time intervals after surgery. A total of 249 patients underwent the procedure, and follow-up extends up to 10 years.

    Article  PubMed  Google Scholar 

  19. • 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(4):577–85. This paper provides clinical outcomes at a single study center with 100 patients at 3–6 years post magnetic sphincter augmentation, and contains detailed adverse effects profile of the procedure.

    Article  PubMed  Google Scholar 

  20. • Muls V, Eckardt AJ, Marchese M, et al. Three-year results of a multicenter prospective study of transoral incisionless fundoplication. Surg Innov. 2012;20(4):321–30. This paper is one of the only papers with long-term data on the use of TIF for GERD: 66 patients were followed up to a median of 3.1 years with detailed intention to treat analysis for this procedure.

    Article  PubMed  Google Scholar 

  21. Broeders JA, Roks DJ, Ahmed AU, et al. Laparoscopic anterior versus posterior fundoplication for gastroesophageal reflux disease: systemic review and meta-analysis of randomized trials. Ann Surg. 2012;255:637–42.

    Article  PubMed  Google Scholar 

  22. Velanovich V. Comparison of generic (SF-36) vs disease specific quality-of-life (GERD-HRQL) scales for gastroesophageal disease. J Gastrointest Surg. 1998;2:141–5.

    Article  CAS  PubMed  Google Scholar 

  23. Wendling MR, Melvin SW. Impact of transoral incisionless fundoplication (TIF) on subjective and objective GERD indices: a systemic review of the published literature. Surg Endosc. 2013;27(10):3754–61.

    Article  PubMed  Google Scholar 

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Conflict of Interest

Robert Ganz has no conflicts of interest. Michael Min has no conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by the author.

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Authors and Affiliations

  1. Department of Medicine, Abbott Northwestern Hospital, Minneapolis, MN, USA

    Michael X. Min & Robert A. Ganz

  2. Minnesota Gastroenterology, PA, Plymouth, MN, USA

    Michael X. Min & Robert A. Ganz

  3. Department of Gastroenterology, University of Minnesota, Minneapolis, MN, USA

    Michael X. Min & Robert A. Ganz

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  1. Michael X. Min
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  2. Robert A. Ganz
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Correspondence to Robert A. Ganz.

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This article is part of the Topical Collection on Esophagus

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Min, M.X., Ganz, R.A. Update in Procedural Therapy for GERD – Magnetic Sphincter Augmentation, Endoscopic Transoral Incisionless Fundoplication vs Laparoscopic Nissen Fundoplication. Curr Gastroenterol Rep 16, 374 (2014). https://doi.org/10.1007/s11894-014-0374-4

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  • DOI: https://doi.org/10.1007/s11894-014-0374-4

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