Modern GERD treatment: feasibility of minimally invasive esophageal sphincter augmentation.
BACKGROUND
Gastroesophageal reflux disease (GERD) is a common chronic disease requiring adequate treatment since it represents one major cause of development of Barrett's esophagus and eventually carcinoma. Novel laparoscopic magnetic sphincter augmentation for GERD was evaluated prospectively.


METHODS
A total of 23 patients with GERD underwent minimally invasive implantation of LINX™ Reflux Management System. Primary outcome measures were overall feasibility, short-term procedure safety and efficacy. Secondary GERD-related quality of life was assessed.


RESULTS
All implantations were performed without serious adverse events. A significant decrease in all major GERD complaints were found: heartburn: 96%-22% (p<0.001); bloating: 70%-30% (p=0.006); respiratory complaints: 57%-17% (p=0.039); sleep disturbance: 65%-4% (p<0.001). A four-week follow-up reduction of ≥50% of proton pump inhibitor (PPI) dose was achieved in over 80% of patients. Self-limiting difficulty in swallowing was found in 70% within four weeks. One patient required for endoscopic dilation. GERD-related quality of life improved significantly.


CONCLUSIONS
LINX™ implantation is a standardized, technically simple, safe and well-tolerated expeditious procedure.
Department of Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. sebastian.schoppmann@meduniwien.ac.at.
Katrin
K
Schwameis
Michael
M
Schwameis
Barbara
B
Zörner
Johannes
J
Lenglinger
Reza
R
Asari
Franz Martin
FM
Riegler
Sebastian Friedrich
SF
Schoppmann
D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D049630:Esophageal Sphincter, Lower / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology; D019736:Prostheses and Implants; D016896:Treatment Outcome; D055815:Young Adult
GERD; LINX™; esophageal sphincter; laparoscopy; reflux