Blog / Longer Term Outcomes Of Gastroesophageal Reflux Disease Treated With Magnetic Sphincter Augmentation
Aiysha Puri, Sue Steven, Sheraz R Markar, Nicholas Boyle, Diseases of the Esophagus, doad014, https://doi.org/10.1093/dote/doad014
Find the abstract to the study here; https://pubmed.ncbi.nlm.nih.gov/36942526/
A report of the outcomes in 200 patients who underwent LINX®️ surgery to treat gastro-esophageal reflux disease (GERD) and followed up for 5 years. It is one of the largest long-term studies yet published. There is no previously published study approaching the size or length of follow-up published in UK patients. It was accepted by one of the world’s most respected scientific publications Diseases of the Esophagus published by Oxford Academic. The data was collected prospectively i.e. with a view to publishing the results.
Patients included in the study had no hiatus hernias, as well as those with hiatus hernias up to 8cm in length, and were aged 18-80 years of age.
The procedure is safe; there were no complications during the procedure or device erosions thereafter.
GERD symptoms were measured using the GERD-HRQL, a validated and accepted scoring tool recording heartburn, regurgitation and other oesophageal type symptoms. LPR symptoms were measured using the validated Reflux Symptom Index (RSI).
Prior to surgery, the median GERD-HRQL score was 32 (IQR 16-39), and the median RSI Score was 15.5 (IQR 9-25).
Following LINX, there were significant and sustained improvements in quality of life; GERD-HRQL scores fell significantly and remained controlled at all times up to five years following surgery. At the latest follow-up, HRQL scores had dropped on average from 32 before surgery, to 0.
LPR type symptoms also fell significantly and again remained controlled over the long-term. At the latest follow-up, RSI scores had dropped from on average 15.5 prior to surgery to 0.
This is an important study for patients, doctors treating GERD and for RefluxUK.
Firstly, it reflects RefluxUK’s commitment to publish our results and re-emphasises our experience and dedication to achieve excellent outcomes for our patients. We are committed to evidence-based practice and to contributing to help everyone reach the best available outcomes. At the time of publication there have been no similar UK studies published in terms of numbers of patients or length of follow up, and indeed this is one of the largest of its kind globally.
It's shocking that average length of time that people had experienced symptoms prior to surgery was nearly 20 years and that they’d been taking PPIs for an average of 10. While in many, their symptoms slowly deteriorated until they sought an operation, many others would undoubtedly have considered an anti-reflux operation earlier if they’d been offered one.
Firstly, good outcomes are related to careful patient selection, tailoring treatment individually, using a Multi-Disciplinary Team structure and sharing decision making with patients. These elements have always been central to the RefluxUK philosophy. But specialisation and volume also contribute to achieving good results and there is published evidence from studies in fundoplication confirming that this is the case. In our hands virtually everyone will return home on the day of their operation and resume normal day to day activities within a few days.
Regardless, these results confirm that for many people, LINX®️ sphincter augmentation can achieve excellent results and, in our view, should be available earlier and to many more suffering with reflux symptoms.
Read more about the LINX®️ procedure
Also, an alternative insight into this study from a patient perspective is available.