How to choose among fundoplication, magnetic sphincter augmentation or transoral incisionless fundoplication. Issue 4 (July 2019)

• Record Type: Journal Article
• Authors: Rabach, Lauren; Saad, Adham R.; Velanovich, Vic
• Is Part Of: Current opinion in gastroenterology. Volume 35:Issue 4(2019)
• Publication Date: 2019-07
• Subjects: fundoplication -- gastroesophageal reflux -- magnetic sphincter augmentation -- transoral incisionless fundoplication; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1097/MOG.0000000000000550
• Languages: English
• ISSNs: 0267-1379

Abstract

Abstract : Purpose of review: To examine current trends and research in nonmedical approaches to the treatment of gastroesophageal reflux disease (GERD). Recent findings: Long-term studies of GERD patients treated with transoral incisionless fundoplication (TIF) have found that a large portion of patients resume proton pump inhibitor therapy. In patients with uncomplicated GERD, magnetic sphincter augmentation (MSA) shows excellent short-term results in both patient satisfaction and physiologic measures of GERD, with fewer postoperative side-effects than fundoplication, although dysphagia can be problematic. Summary: Fundoplication remains the standard of care for patients with GERD complicated by hiatal hernias more than 2 cm, Barrett's esophagus and/or grade C and D erosive esophagitis. For the patient with uncomplicated GERD, MSA appears to be a viable alternative that has greater technical standardization and fewer postoperative side-effects than fundoplication. TIF remains an option for patients with refractory GERD who refuse surgical intervention.