Minimal versus obligatory dissection of the diaphragmatic hiatus during magnetic sphincter augmentation surgery

Surgical Endoscopy
James M TatumJohn C Lipham

Abstract

The magnetic sphincter augmentation (MSA) device was initially implanted with minimal hiatal dissection (MHD) at the diaphragmatic hiatus. Due to concern of possible MSA device dysfunction if herniated into an occult or small hiatal hernia, and increased understanding to the role of defective crura in reflux disease, the operative procedure was changed to planned obligatory dissection (OD) of the hiatus at the time of all implantations. Between December 2012 and September 2016, 182 patients underwent MSA implant at a single medical center and have complete records available for review through September 2017. The MHD dissection period extended from December 2012 to September 2015, from September 2015 to 2016 all patients underwent OD. MHD occurred 53% (96/182) versus OD in 47% (86/182), mean follow-up time in days for MHD and OD was 554 (SD 427) versus 374 (298) days. Intraoperative measurement of hernia size for the MHD versus OD was 0.77 (1.1) versus 3.95 (2.4) cm, p < 0.001. At first visit follow-up, there was no difference in any dysphagia (p = 0.11). Recurrent GERD (defined as resumption of PPI after successful initial post-operative wean) was less frequent after OD than after MHD, 3.6 versus 16.3%, p = 0.006. Delayed onset...Continue Reading

References

Dec 16, 1982·The New England Journal of Medicine·W J DoddsM S Egide
Sep 11, 1999·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·M FeinC G Bremner
Aug 18, 2005·Thoracic Surgery Clinics·Peter J Kahrilas, Thomas J Lee
Jan 21, 2006·World Journal of Surgery·Ahmed ShafikRanda M Mostafa
Nov 27, 2008·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Landino FeiAlberto del Genio
Apr 28, 2012·Surgical Endoscopy·John C LiphamWillem Bemelman
Nov 29, 2012·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Brian E LouieRalph W Aye
Feb 22, 2013·The New England Journal of Medicine·Robert A GanzPaul A Taiganides
Mar 13, 2014·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·J C LiphamT R Demeester
Jun 6, 2015·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Robert A GanzDan Dunn
Jul 16, 2016·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·M Â N E SouzaD Sifrim
Aug 25, 2016·Surgical Endoscopy·Kais A RonaJohn C Lipham

❮ Previous
Next ❯

Citations

Apr 9, 2020·Annals of the New York Academy of Sciences·Luigi BonavinaRoger P Tatum
May 14, 2020·Current Opinion in Gastroenterology·Jason A SterrisJohn C Lipham
Apr 14, 2020·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Catherine TsaiJoerg Zehetner
Dec 22, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Emanuele RausaMarco Antonio Zappa
Mar 10, 2020·Gastrointestinal Endoscopy Clinics of North America·Steven R DeMeester
Apr 23, 2021·Journal of Clinical Gastroenterology·Colin P DunnJohn C Lipham

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

Medical Record News
R Baird
JAMA : the Journal of the American Medical Association
R A Burt
Magnetic Resonance in Medicine : Official Journal of the Society of Magnetic Resonance in Medicine
Waltraud B BuchenbergBernd Jung
European Journal of Respiratory Diseases
G KjellénB Wranne
© 2022 Meta ULC. All rights reserved