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Published on: January 2, 2020
Magnetic sphincter augmentation: Optimal patient selection and referral care pathways
F Paul Buckley1, Benjamin Havemann2, Amarpreet Chawla3
1Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX 78712, United States. tripp.buckley@austin.utexas.edu.
Magnetic sphincter augmentation (MSA) is optimal for a specific subset of GERD patients unresponsive to medication. Improving care pathways involves multidisciplinary collaboration for better patient outcomes.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Patient Care Pathways
Background:
- Magnetic sphincter augmentation (MSA) offers an alternative for refractory gastroesophageal reflux disease (GERD).
- Optimal patient selection and care coordination for MSA remain underexplored.
- Current GERD management pathways may not be fully optimized.
Purpose of the Study:
- To define the optimal patient profile for MSA.
- To outline diagnostic criteria for identifying suitable candidates.
- To propose improvements in GERD patient care pathways.
Main Methods:
- Systematic review of MEDLINE/EMBASE publications (2000-2018).
- Inclusion of clinical guidelines.
- Expert clinical experience contextualization.
Main Results:
- Optimal MSA candidates represent 2.2-2.4% of GERD patients with persistent symptoms despite medical management.
- Key diagnostic tools include pH monitoring, high-resolution manometry, barium swallow, and endoscopy.
- Multidisciplinary involvement is crucial, extending beyond PCPs and GIs.
Conclusions:
- MSA is best suited for a select group of GERD patients with specific diagnostic findings.
- Objective testing is essential for determining surgical candidacy.
- Enhanced collaboration among patients, providers, and surgeons can optimize GERD care pathways.
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