Authors: Jessica L Reynolds Joerg Zehetner Angela Nieh Nikolai Bildzukewicz Kulmeet Sandhu Namir Katkhouda John C Lipham
Publish Date: 2015/11/05
Volume: 30, Issue: 8, Pages: 3225-3230
Abstract
Magnetic sphincter augmentation MSA is approved for uncomplicated GERD Multiple studies have shown MSA to compare favorably to laparoscopic Nissen fundoplication LNF in terms of symptom control with results out to 5 years The MSA device itself however is an added cost to an antireflux surgery and direct cost comparison studies have not been done between MSA and LNF The aim of the study was to compare charges complications and outcome of MSA versus LNF at 1 yearThis is a retrospective analysis of all patients who underwent MSA or LNF for the treatment of GERD between January 2010 and June 2013 Patient charges were collected for the surgical admission We also collected data on 30day complications and symptom control at 1 year assessed by GERDHRQL score and PPI useThere were 119 patients included in the study 52 MSA and 67 LNF There was no significant difference between the mean charges for MSA and LNF 48491 vs 50111 p = 0506 There were significant differences in OR time 66 min MSA vs 82 min LNF p 001 and LOS 17 h MSA vs 38 h LNF p 001 At 1year followup mean GERDHRQL was 43 for MSA versus 51 for LNF p = 047 and 85 of MSA patients versus 92 of LNF patients were free from PPIs p = 037 MSA patients reported less gas bloat symptoms 23 vs 53 p ≤ 001 and inability to belch 10 vs 36 p ≤ 001 and vomit 4 vs 19 p ≤ 001The side effect profile of MSA is better than LNF as evidenced by less gas bloat and increase ability to belch and vomit LNF and MSA are comparable in symptom control safety and overall hospital charges The charge for the MSA device is offset by less charges in other categories as a result of the shorter operative time and LOS
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