To assess the short-term perioperative outcomes of patients undergoing magnetic sphincter augmentation (MSA) device explant with concurrent hiatal hernia repair (HHR) and fundoplication compared to outcomes from primary HHR and fundoplication.
Approach:
Data source and study design: A retrospective cohort study using the ACS-NSQIP registry from 2017 to 2023, analyzing outcomes up to 30 days postoperatively.
Patient population: Included adults (18 years and older) undergoing foregut surgery, identified using specific CPT codes.
Variables and outcomes: Baseline characteristics and primary outcomes of interest included 30-day complications, operative time, length of stay, readmission, reoperation, and mortality.
Statistical analysis: Propensity score matching was used to minimize confounding, with statistical significance defined as p < 0.05.
Key Findings:
A total of 49,535 patients underwent foregut surgery; 40 patients (0.01%) had concurrent MSA device explant.
No significant differences in 30-day outcomes between cohorts; 97.5% of patients experienced no complications.
Median operative time was similar: 135 min for MSA device explant and 132 min for the control cohort.
Median length of stay was equivalent at 1 day for both groups.
Interpretation:
Concurrent MSA device explant with HHR and fundoplication has a short-term safety profile similar to primary HHR and fundoplication, with no significant differences in complications or operative metrics.
Limitations:
The study is limited to short-term outcomes and may not reflect long-term complications or benefits.
The small number of patients undergoing MSA device explant limits the generalizability of the findings.
Conclusion:
The findings indicate that MSA device explantation and conversion to traditional fundoplication have few complications, similar to primary HHR and fundoplication.
