Crural Closure improves Outcomes of Magnetic Sphincter Augmentation in GERD patients with Hiatal Hernia

Abstract Magnetic sphincter-augmentation (MSA) has been proven effective in the treatment of GERD. No consensus exists on whether crural closure should be performed. Our aim was to assess the impact of cruroplasty on reflux-control and quality of life. MSA-Patients treated between 03/2012-03/2017 we...

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Autores principales:	Katrin Schwameis, Milena Nikolic, Deivis G. Morales Castellano, Ariane Steindl, Sarah Macheck, M. Riegler, Ivan Kristo, Barbara Zörner, Sebastian F. Schoppmann
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9ca0076938814a529faa0668fdbdfaa3
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spelling	oai:doaj.org-article:9ca0076938814a529faa0668fdbdfaa32021-12-02T15:08:28ZCrural Closure improves Outcomes of Magnetic Sphincter Augmentation in GERD patients with Hiatal Hernia10.1038/s41598-018-24322-12045-2322https://doaj.org/article/9ca0076938814a529faa0668fdbdfaa32018-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-24322-1https://doaj.org/toc/2045-2322Abstract Magnetic sphincter-augmentation (MSA) has been proven effective in the treatment of GERD. No consensus exists on whether crural closure should be performed. Our aim was to assess the impact of cruroplasty on reflux-control and quality of life. MSA-Patients treated between 03/2012-03/2017 were classified into those without hiatal hernia (“NHH”), those post-MSA (NHR) and those post-MSA/hiatal repair (HR). GERD-symptoms, PPI-intake, GERD-Health-related-Quality-of-Life (GERD-HRQL) and Alimentary Satisfaction were assessed. Sixty-eight patients underwent MSA, 26 patients had additional crural closure. PH-monitoring was negative in 80% of HR, 73% of NHR and 89% of NHH-patients. GERD-HRQL-total scores decreased significantly in all groups (p < 0.001). Alimentary satisfaction was 8/10 in HR/NHH and 10/10 in NHR-patients. Satisfaction with heartburn relief was high (HR: 96%, NR: 95%, NHH: 94%) as was the elimination of PPI-intake (HR/NHH: 87%, NR: 86%). Heartburn and regurgitations were eliminated in 100% of HR, 88% and 94% of NHR and 87% and 91% of NHH-patients. Endoscopic dilatation or device explantation was performed in 3% each. MSA leads to significant symptom relief, increased quality of life and alimentary satisfaction with low perioperative morbidity. Cruroplasty tends to result in better reflux control and symptom relief than exclusive MSA without increasing dysphagia rates.Katrin SchwameisMilena NikolicDeivis G. Morales CastellanoAriane SteindlSarah MacheckM. RieglerIvan KristoBarbara ZörnerSebastian F. SchoppmannNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-7 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Katrin Schwameis Milena Nikolic Deivis G. Morales Castellano Ariane Steindl Sarah Macheck M. Riegler Ivan Kristo Barbara Zörner Sebastian F. Schoppmann Crural Closure improves Outcomes of Magnetic Sphincter Augmentation in GERD patients with Hiatal Hernia
description	Abstract Magnetic sphincter-augmentation (MSA) has been proven effective in the treatment of GERD. No consensus exists on whether crural closure should be performed. Our aim was to assess the impact of cruroplasty on reflux-control and quality of life. MSA-Patients treated between 03/2012-03/2017 were classified into those without hiatal hernia (“NHH”), those post-MSA (NHR) and those post-MSA/hiatal repair (HR). GERD-symptoms, PPI-intake, GERD-Health-related-Quality-of-Life (GERD-HRQL) and Alimentary Satisfaction were assessed. Sixty-eight patients underwent MSA, 26 patients had additional crural closure. PH-monitoring was negative in 80% of HR, 73% of NHR and 89% of NHH-patients. GERD-HRQL-total scores decreased significantly in all groups (p < 0.001). Alimentary satisfaction was 8/10 in HR/NHH and 10/10 in NHR-patients. Satisfaction with heartburn relief was high (HR: 96%, NR: 95%, NHH: 94%) as was the elimination of PPI-intake (HR/NHH: 87%, NR: 86%). Heartburn and regurgitations were eliminated in 100% of HR, 88% and 94% of NHR and 87% and 91% of NHH-patients. Endoscopic dilatation or device explantation was performed in 3% each. MSA leads to significant symptom relief, increased quality of life and alimentary satisfaction with low perioperative morbidity. Cruroplasty tends to result in better reflux control and symptom relief than exclusive MSA without increasing dysphagia rates.
format	article
author	Katrin Schwameis Milena Nikolic Deivis G. Morales Castellano Ariane Steindl Sarah Macheck M. Riegler Ivan Kristo Barbara Zörner Sebastian F. Schoppmann
author_facet	Katrin Schwameis Milena Nikolic Deivis G. Morales Castellano Ariane Steindl Sarah Macheck M. Riegler Ivan Kristo Barbara Zörner Sebastian F. Schoppmann
author_sort	Katrin Schwameis
title	Crural Closure improves Outcomes of Magnetic Sphincter Augmentation in GERD patients with Hiatal Hernia
title_short	Crural Closure improves Outcomes of Magnetic Sphincter Augmentation in GERD patients with Hiatal Hernia
title_full	Crural Closure improves Outcomes of Magnetic Sphincter Augmentation in GERD patients with Hiatal Hernia
title_fullStr	Crural Closure improves Outcomes of Magnetic Sphincter Augmentation in GERD patients with Hiatal Hernia
title_full_unstemmed	Crural Closure improves Outcomes of Magnetic Sphincter Augmentation in GERD patients with Hiatal Hernia
title_sort	crural closure improves outcomes of magnetic sphincter augmentation in gerd patients with hiatal hernia
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/9ca0076938814a529faa0668fdbdfaa3
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Crural Closure improves Outcomes of Magnetic Sphincter Augmentation in GERD patients with Hiatal Hernia

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