TY - JOUR
TI - LINX® reflux management system to bridge the "treatment gap" in gastroesophageal reflux disease: A systematic review of 35 studies
AU - Schizas, D.
AU - Mastoraki, A.
AU - Papoutsi, E.
AU - Giannakoulis, V.G.
AU - Kanavidis, P.
AU - Tsilimigras, D.
AU - Ntourakis, D.
AU - Lyros, O.
AU - Liakakos, T.
AU - Moris, D.
JO - WORLD JOURNAL OF CLINICAL CASES
PY - 2020
VL - 8
TODO - 2
SP - 294-305
PB - Baishideng Publishing Group Co
SN - null
TODO - 10.12998/wjcc.v8.i2.294
TODO - proton pump inhibitor, Article;  bariatric surgery;  clinical outcome;  cost effectiveness analysis;  dysphagia;  erosion;  esophageal erosion;  follow up;  gastroesophageal junction;  gastroesophageal reflux;  heartburn;  human;  laparotomy;  length of stay;  meta analysis;  nuclear magnetic resonance imaging;  operation duration;  patient satisfaction;  quality of life;  surgical approach;  surgical technique;  systematic review
TODO - BACKGROUND Gastroesophageal reflux disease (GERD) occurs when the reflux of stomach contents causes troublesome symptoms and/or complications. When medical therapy is insufficient, surgical therapy is indicated and, until now, Laparoscopic fundoplication (LF) constitutes the gold-standard method. However, magnetic sphincter augmentation (MSA) using the LINX® Reflux Management System has recently emerged and disputes the standard therapeutic approach. AIM To investigate the device's safety and efficacy in resolving GERD symptoms. METHODS This is a systematic review conducted in accordance to the PRISMA guidelines. We searched MEDLINE, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL databases from inception until September 2019. RESULTS Overall, 35 studies with a total number of 2511 MSA patients were included and analyzed. Post-operative proton-pump inhibitor (PPI) cessation rates reached 100%, with less bloating symptoms and a better ability to belch or vomit in comparison to LF. Special patient groups (e.g., bariatric or large hiatal-hernias) had promising results too. The most common postoperative complication was dysphagia ranging between 6% and 83%. Dilation due to dysphagia occurred in 8% of patients with typical inclusion criteria. Esophageal erosion may occur in up to 0.03% of patients. Furthermore, a recent trial indicated MSA as an efficient alternative to double-dose PPIs in moderate-to-severe GERD. CONCLUSION The findings of our review suggest that MSA has the potential to bridge the treatment gap between maxed-out medical treatment and LF. However, further studies with longer follow-up are needed for a better elucidation of these results. © 2020 The Author(s).
ER -