Efficacy of Magnetic Sphincter Augmentation versus Nissen Fundoplication for Gastroesophageal Reflux Disease in Short Term: A Meta-Analysis.
Efficacy of Magnetic Sphincter Augmentation versus Nissen Fundoplication for Gastroesophageal Reflux Disease in Short Term: A Meta-Analysis.
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DOI：
10.1155/2017/9596342
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发表时间：
2017
影响因子：
2.7
通讯作者：
Cai XJ
中科院分区：
文献类型：
--
作者：
Chen MY;Huang DY;Wu A;Zhu YB;Zhu HP;Lin LM;Cai XJ
背景磁括约肌增强术（MSA）治疗胃食管反流病（GERD）的疗效及其结局尚不确定。因此，我们的目的是总结和分析两种治疗GERD的疗效。方法.使用4个数据库进行荟萃分析检索。2005年至2016年的所有研究均纳入其中。使用固定或随机效应模型计算合并效应。结果共有4项试验纳入624例患者，旨在评价质子泵抑制剂使用、并发症和不良事件的差异。MSA的手术时间较短（MSA和NF：RR = −18.80，95%CI：−24.57至−13.04，P = 0.001），住院时间较短（RR = −14.21，95%CI：−24.18至−4.23，P = 0.005）。两组的质子泵抑制剂使用、并发症（P = 0.19）和扩张导致的重度吞咽困难相似。虽然MSA和NF之间的不良事件数量没有差异，但术后胀气或腹胀的发生率（RR = 0.71，95%CI：0.54-0.94，P = 0.02）显示出显著差异。然而，在打嗝和呕吐的能力方面没有显著差异。结论.根据近期研究，MSA可推荐作为GERD的替代治疗，尤其是在以气胀为主要特征的GERD中，由于手术时间短，气胀或气胀并发症少。
Background. The efficacy of Magnetic Sphincter Augmentation (MSA) and its outcomes for Gastroesophageal Reflux Disease (GERD) are uncertain. Therefore, we aimed to summarize and analyze the efficacy of two treatments for GERD. Methods. The meta-analysis search was performed, using four databases. All studies from 2005 to 2016 were included. Pooled effect was calculated using either the fixed or random effects model. Results. A total of 4 trials included 624 patients and aimed to evaluate the differences in proton-pump inhibitor use, complications, and adverse events. MSA had a shorter operative time (MSA and NF: RR = −18.80, 95% CI: −24.57 to −13.04, and P = 0.001) and length of stay (RR = −14.21, 95% CI: −24.18 to −4.23, and P = 0.005). Similar proton-pump inhibitor use, complication (P = 0.19), and severe dysphagia for dilation were shown in both groups. Although there is no difference between the MSA and NF in the number of adverse events, the incidence of postoperative gas or bloating (RR = 0.71, 95% CI: 0.54–0.94, and P = 0.02) showed significantly different results. However, there is no significant difference in ability to belch and ability to vomit. Conclusions. MSA can be recommended as an alternative treatment for GERD according to their short-term studies, especially in main-features of gas-bloating, due to shorter operative time and less complication of gas or bloating.