کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5657371 | 1407401 | 2017 | 37 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
A Modern Magnetic Implant for Gastroesophageal Reflux Disease
ترجمه فارسی عنوان
ایمپلنت مغناطیسی مدرن برای بیماری ریفلاکس معده
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کلمات کلیدی
FDALESPPIHRQOLGERDGastroesophageal junction - اتصال مفاصل معدهLower esophageal sphincter - اسفنکتر مری پایینgastroesophageal reflux disease - بیماری ریفلاکس معده به مریGEJ - جی جیGastroesophageal reflux - ریفلاکس معدهFood and Drug Administration - سازمان غذا و داروNissen fundoplication - سرمایه گذاری نیسنbody mass index - شاخص توده بدنBMI - شاخص توده بدنیProton pump inhibitors - مهار کننده های پمپ پروتونProton-pump inhibitor - مهارکننده پروتون-پمپHealth-related quality of life - کیفیت زندگی مرتبط با سلامت
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
بیماریهای گوارشی
چکیده انگلیسی
A magnetic implant for the treatment of gastroesophageal reflux disease (GERD) was Food and Drug Administration-approved in 2012 and has been extensively evaluated. The device is a ring of magnets that are placed around the gastroesophageal junction, augmenting the native lower esophageal sphincter and preventing reflux yet preserving lower esophageal sphincter physiologic function and allowing belching and vomiting. Magnetic force is advantageous, being permanent and precise, and forces between magnets decrease with esophageal displacement. Multiple patient cohorts have been studied using the magnetic device, and trials establish consistent, long-term improvement in pH data, GERD symptom scores, and proton-pump inhibitor use. A 5-year Food and Drug Administration trial demonstrated that most patients achieved normal pH scores, 85% stopped proton-pump inhibitors, and GERD health-related quality of life symptom scores improved from 27 to 4 at 5 years. Seven studies have compared magnetic augmentation with laparoscopic Nissen fundoplication and demonstrated that the magnetic device achieved comparable efficacy with regard to proton-pump inhibitor cessation, GERD symptom score improvement, and heartburn and regurgitation scores. However, to date there have been no randomized, controlled trials comparing the 2 techniques, and the study cohorts are not necessarily comparable regarding hiatal hernia size, severity of reflux, body mass index scores, or esophagitis scores. Dysphagia incidence was similar in both groups. Reoperation rates and safety profiles were also comparable, but the magnetic device demonstrated significant beneficial differences in allowing belching and vomiting. The magnetic device is safe, with the main adverse event being dysphagia with an approximate 3%-5% chronic incidence. Device removals in clinical trials have been between 0% and 7% and were uneventful. There have been no erosions, perforations, or infections in FDA clinical trials; erosions have rarely been noted in practice. Magnetic augmentation of the lower esophageal sphincter is a safe and effective operation for GERD, and should be considered a surgical option for those seeking a fundic-sparing operation, particularly those with parameters consistent with study cohorts. Additional randomized, controlled trials are underway.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Clinical Gastroenterology and Hepatology - Volume 15, Issue 9, September 2017, Pages 1326-1337
Journal: Clinical Gastroenterology and Hepatology - Volume 15, Issue 9, September 2017, Pages 1326-1337
نویسندگان
Robert A. Ganz,