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Short term safety of magnetic sphincter augmentation vs minimally invasive fundoplication: an ACS-NSQIP analysis.
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- Author(s): Wisniowski, Paul; Putnam, Luke R.; Gallagher, Shea; Rawal, Rushil; Houghton, Caitlin; Lipham, John C.
- Source:
Surgical Endoscopy & Other Interventional Techniques; Apr2024, Vol. 38 Issue 4, p1944-1949, 6p- Subject Terms:
MORTALITY; PNEUMONIA; URINARY tract infections; PATIENT safety; LAPAROSCOPIC surgery; PATIENT readmissions; HISPANIC Americans; MULTIPLE regression analysis; FISHER exact test; MINIMALLY invasive procedures; TREATMENT effectiveness; MULTIVARIATE analysis; CHI-squared test; AGE distribution; TREATMENT duration; DESCRIPTIVE statistics; WHITE people; SURGICAL complications; ODDS ratio; FUNDOPLICATION; REOPERATION; QUALITY assurance; COMPARATIVE studies; LENGTH of stay in hospitals; CONFIDENCE intervals; DATA analysis software; GASTROESOPHAGEAL reflux; COMORBIDITY; EVALUATION - Source:
- Additional Information
- Abstract: Purpose: Magnetic Sphincter Augmentation (MSA) is an FDA-approved anti-reflux procedure with comparable outcomes to fundoplication. However, most data regarding its use are limited to single or small multicenter studies which may limit the generalizability of its efficacy. The purpose of this study is to evaluate the outcomes of patients undergoing MSA vs fundoplication in a national database. Materials and Methods: The 2017–2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Registry was utilized to evaluate patients undergoing MSA or fundoplication. Patients requiring Collis gastroplasty, paraesophageal hernia repair, and emergency cases, were excluded. Patient outcomes included overall complication rates, readmissions, reoperations, and mortality. Results: A total of 7,882 patients underwent MSA (n = 597) or fundoplication (n = 7285). MSA patients were younger (51 vs 57, p < 0.001), and more often male (49.6 vs 34.3%, p < 0.001). While patients undergoing MSA experienced similar rates of reoperation (1.0 vs 2.0%, p = 0.095), they experienced fewer readmissions (2.2 vs 4.7%, p = 0.005), complications (0.6 vs 4.0%, p < 0.001), shorter mean (SD) hospital length of stay(days) (0.4 ± 4.3 vs 1.8 ± 4.6, p < 0.001) and operative time(min) (80.8 ± 36.1 vs 118.7 ± 63.7, p < 0.001). Mortality was similar between groups (0 vs 0.3%, p = 0.175). On multivariable analysis, MSA was independently associated with reduced postoperative complications (OR 0.23, CI 0.08 to 0.61, p = 0.002), readmissions (OR 0.53, CI 0.30 to 0.94, p = 0.02), operative time (RC − 36.56, CI − 41.62 to − 31.49. p < 0.001) and length of stay (RC − 1.22, CI − 1.61 to − 0.84 p < 0.001). Conclusion: In this national database study, compared to fundoplication MSA was associated with reduced postoperative complications, fewer readmissions, and shorter operative time and hospital length of stay. While randomized trials are lacking between MSA and fundoplication, both institutional and national database studies continue to support the use of MSA as a safe anti-reflux operation. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Surgical Endoscopy & Other Interventional Techniques is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Abstract:
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