LINX comparable to Nissen fundoplication in GERD symptom improvement
Laparoscopic magnetic sphincter augmentation with the LINX device achieved GERD symptom control comparable to that of laparoscopic Nissen fundoplication, according to retrospective study data.
“This is the first propensity-matched study comparing LINX [Torax Medical] to [laparoscopic Nissen fundoplication] assessing quality of life, proton-pump inhibitor use, satisfaction and complications,” John C. Lipham, MD, chief of the division of upper GI and general surgery and associate professor of clinical surgery at Keck School of Medicine of the University of Southern California, said in a press release. “This study validates the LINX results shown in other studies and substantiates that LINX is as effective as LNF in controlling reflux. It further supports the use of LINX as a first line therapy in patients who are failing drugs to control their reflux.”
To assess safety and efficacy of both procedures in GERD patients with similar disease severity, Lipham and colleagues analyzed 1-year outcomes of propensity-matched patients who underwent LINX (n = 50) or laparoscopic Nissen fundoplication (LNF; n = 50) performed by the same three surgeons at the same two institutions between June 2010 and June 2013. Outcomes were evaluated based on the GERD-Health Related Quality of Life (HRQL) survey, PPI use, patient satisfaction and complications.
A year after surgery, LINX and LNF groups had comparable GERD-HRQL scores (4.2 vs. 4.3), PPI discontinuation (83% vs. 91.5%), mild dysphagia (36.2% vs. 31.9%), moderate-to-severe dysphagia (10.6% vs. 12.8%) and reports of mild gas and bloating. Severe gas and bloating was reported by none of the LINX patients compared with 10.6% of the LNF group (P = .022). Inability to belch was reported by 8.5% of the LINX group compared with 25.5% of the LNF group (P = .028), and inability to vomit was reported in 4.3% and 21.3%, respectively (P = .004).
Satisfaction with the procedure was reported by 89.4% of the LINX group and 92.5% of the LNF group, and 93.6% vs. 80.9% said they would undergo the procedure again.
“Analogous GERD patients had similar control of reflux symptoms after both [magnetic sphincter augmentation] and LNF,” the researchers wrote. “Annoying inabilities to belch and vomit and severe gas-bloat symptoms were significantly fewer with [magnetic sphincter augmentation]. The more favorable side effect profile of [magnetic sphincter augmentation] supports its use early in the course of GERD.” – by Adam Leitenberger
Disclosure: Lipham reports he is a consultant for Torax Medical. All other authors report no relevant financial disclosures.