Family History of GERD Does Not Predict Anti-Reflux Surgery Outcomes.

BACKGROUND AND OBJECTIVES: Gastroesophageal reflux disease is a common disease and there is little known about the role family history plays in its disease process and incidence. Our study was designed to compare the patients with first degree relatives with and without the disease and see if there was any difference in patients needing antireflux surgery, the outcomes after antireflux surgery, and whether they needed redo surgery. METHODS: An institutional review board approved registry for patients undergoing antireflux surgery at a single institution was used. Patients were asked specific questions about their family history of gastroesophageal reflux disease at their pre-operative visit. Patients with a family history and those without were compared. RESULTS: There was no statistical difference between the patients with family history of gastroesophageal reflux disease for likelihood to undergo surgery, outcomes from surgery, or the need for redo surgery. There were more females than males in the study and there were more patients with a positive family history in the study than those without. CONCLUSION: Since there is no impact of family history of gastroesophageal reflux disease on antireflux surgery, patients can be counseled that their decision to undergo antireflux surgery is independent from the response of their first degree relatives.

Safety of magnetic sphincter augmentation in patients with prior bariatric and anti-reflux surgery.

BACKGROUND: Magnetic sphincter augmentation (MSA) has been recognized as an effective treatment option for patients with gastroesophageal reflux disease. The feasibility of MSA in patients with prior gastric surgery has not been well established. This study aims to evaluate the safety and efficacy of MSA in patients with prior gastric surgery including bariatric and other anti-reflux operations. METHODS: A prospectively gathered registry approved by the institutional review board for patients undergoing anti-reflux surgery was retrospectively reviewed. All patients who underwent MSA were included. The patients were divided into two groups based on the presence of prior gastric surgeries compared to those without. Endpoints collected include differences between the two groups in their preoperative evaluation, perioperative course, and postoperative effectiveness. RESULTS: A total of 103 patients underwent MSA where 82 patients (80%) had no prior gastric surgery and 21 patients (20%) had prior gastric surgery. The prior gastric surgery group included 10 patients with prior anti-reflux surgery, 11 patients with prior bariatric surgery. Perioperative factors were higher in the prior gastric surgery group including operating room time (135 min vs. 93 min, p = < 0.001), number of beads used (16 vs. 14, p = < 0.001), and percent of patients staying overnight (47% vs. 5%, p = < 0.001). There was no difference in several factors of their preoperative evaluation including preoperative GERD-HRQL and RSI scores, hiatal hernia presence, or DeMeester score. Post-operative GERD-HRQL and RSI scores were not different as well as patient satisfaction, patients resuming PPI use, and device explant rate. CONCLUSIONS: This study demonstrates equivalent outcomes with integration of MSA in patients with prior gastric surgery in comparison to patients without prior gastric surgery. However, these surgeries are longer, require larger devices, and patients are more likely to stay overnight.