Safety and efficacy of magnetic sphincter augmentation dilation.

Surgical Endoscopy
Reid FletcherSteven R DeMeester

Abstract

The magnetic sphincter augmentation device (MSA) provides effective relief of gastroesophageal reflux symptoms. Dysphagia after MSA implantation sometimes prompts endoscopic dilation. The manufacturer's instructions are that it be performed 6 or more weeks after implantation under fluoroscopic guidance to not more than 15 mm keeping 3 or more beads closed. The purpose of this study was to assess adherence to these recommendations and explore the techniques used and outcomes after MSA dilation. We conducted a multicenter retrospective review of patients undergoing dilation for dysphagia after MSA placement from 2012 to 2018. A total of 144 patients underwent 245 dilations. The median size of MSA placed was 14 beads (range 12-17) and the median time to dilation was 175 days. A second dilation was performed in 67 patients, 22 patients had a third dilation and 7 patients underwent 4 or more dilations. In total, 17 devices (11.8%) were eventually explanted. The majority of dilations were performed with a balloon dilator (81%). The median dilator size was 18 mm and 73.4% were done with a dilator larger than 15 mm. There was no association between dilator size and need for subsequent dilation. Fluoroscopy was used in 28% of cases. The...Continue Reading

References

Dec 15, 2011·Annals of Surgery·Joris A BroedersAndré J Smout
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
Jun 23, 2015·Journal of the American College of Surgeons·Jessica L ReynoldsJohn C Lipham
Aug 8, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Shahin AyaziBlair A Jobe

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Citations

Apr 23, 2021·Current Opinion in Gastroenterology·Luigi BonavinaSebastian F Schoppmann
Jun 13, 2021·Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus·Janet DeMarchiAllison Tokarski

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