...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >Removing the magnetic sphincter augmentation device: operative management and outcomes
【24h】

Removing the magnetic sphincter augmentation device: operative management and outcomes

机译：去除磁性括约肌增强装置：操作管理和结果

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BackgroundRecurrent or persistent symptoms of reflux, dysphagia, or device erosion can lead to removal of the magnetic sphincter augmentation (MSA aka Linx) device. Device removal has been previously reported, and outcomes of various surgical management strategies at the time of removal have not been well described.MethodsThis is a retrospective review of patients undergoing MSA removal from March 2009 to September 2017 in a single institution. Reason for removal, operative management, and short-term outcomes are reported.ResultsDuring the study, 435 MSA devices were implanted, 24 of which required removal (5.5%). Removal was due to refractory dysphagia in 1.8% (8/435), for recurrent or persistent GERD in 2.9% (13/435), and secondary to erosion in 0.5% (2/435). Mean time from implant to removal was 863days (range 119-1762 days). The most common reasons for removal were recurrent GERD (54%), dysphagia (38%), or erosion (8%). Significant operative findings included recurrent or progressive hiatal hernia (38%), erosion (8%), and normal anatomy (46%). Hiatal hernia was found and repaired at the time of device removal in 38% of patients (9/24). The MSA device was removed through laparotomy (4%), laparoscopically (88%), or through a combination of endoscopy and laparoscopy (8%). After removal patients underwent repeat MSA (33%), fundoplication (21%), gastrectomy (4%), or no additional procedure (42%). Symptoms prompting removal of the MSA device had resolved in 52% of patients and improved in an additional 35% at last contact. Of the 10 patients having no anti-reflux procedure after removal, 9 were available for follow-up at a mean of 97 (106) days of whom 22.2% (2/9) had symptoms of GERD or required any anti-reflux medication. No major complications occurred after removal.ConclusionMSA removal when necessary can be accomplished through minimally invasive means. Repeat Linx or fundoplication can be performed after removal, however may not be necessary in patients with removal for dysphagia.
机译：背景新闻或持续的回流，吞咽或设备侵蚀症状可以导致磁括约肌增强（MSA AKA LINX）设备的去除。先前已经报道了装置去除，并且在去除时的各种外科管理策略的结果尚未熟悉。方法是从2009年3月到2017年9月在一个机构中接受MSA拆迁的患者的回顾性审查。报告了去除，手术管理和短期结果的原因。植入研究，植入了435个MSA器件，其中24个需要去除（5.5％）。除去由于1.8％（8/435）的难治性吞咽困难，用于2.9％（13/435）的复发或持续的GERD，并在0.5％（2/435）中侵蚀。从植入物中移除的平均时间为863天（范围119-1762天）。去除最常见的原因是复发性GERD（54％），吞咽困难（38％）或侵蚀（8％）。显着的手术结果包括复发性或进行性的血症疝（38％），侵蚀（8％）和正常解剖（46％）。在38％的患者（9/24）中，在设备去除时发现并修复了鞘翅内疝。通过剖腹手术（4％），腹腔镜（88％）或通过内窥镜检查和腹腔镜检查（8％）来除去MSA器件。除去患者后再重复MSA（33％），基础强子术（21％），胃切除术（4％），或者没有其他程序（42％）。症状促使MSA设备的删除已在52％的患者中得到解决，并在最后的接触时额外提高了35％。在除去后没有抗回流术的10名患者中，97个（106）天的平均值可用于22.2％（2/9）的平均随访，其中患有GERD或任何抗反流药物所需的症状。除去后没有发生重症并发症。在必要时，可以通过微创手段来完成必要时去除。可以在去除后进行重复LINX或GOASOPLICY，然而，患有吞咽困难的患者可能不是必要的。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号