Magnetic Sphincter Augmentation Versus Fundoplication in Non-obese Gastroesophageal Reflux Disease (GERD) Patients: A Systematic Review of Patient-Reported Outcomes and Dysphagia
Bibliographic record
Abstract
Magnetic sphincter augmentation (MSA) and laparoscopic fundoplication (LF) are established surgical treatments for gastroesophageal reflux disease (GERD). While several comparative studies exist, evidence specifically focusing on non-obese populations remains less extensively characterized. This systematic review evaluates the effectiveness, functional outcomes, and safety profiles of MSA versus LF in non-obese adults with GERD. The protocol was registered with Prospective Register of Systematic Reviews (PROSPERO: CRD420251106241). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted across PubMed, ScienceDirect, Cochrane Library, and Google Scholar. Comparative studies published from 2015 to 2025 were included if they reported outcomes of MSA and LF in non-obese adults (BMI < 30). Data extraction focused on demographics, GERD-Health Related Quality of Life (GERD-HRQL), proton pump inhibitor (PPI) discontinuation, dysphagia, bloating, belching, and complications. Risk of bias was assessed using the Newcastle-Ottawa Scale. Eight studies with 1,598 patients met the inclusion criteria; 1,078 underwent MSA and 520 received LF. Both interventions significantly improved GERD-HRQL scores. Across the five studies reporting PPI discontinuation, rates were numerically higher with MSA in three studies and higher with LF in two. Overall, findings were mixed and no consistent advantage emerged. MSA patients reported better preservation of belching and reduced bloating. However, persistent dysphagia was more frequent in MSA, with predictors including preoperative dysphagia and weak esophageal motility. Long-term data indicated comparable GERD control but slightly higher reoperation and hernia recurrence rates with MSA. Patient satisfaction was high in both groups, with MSA favored for function-preserving outcomes such as reduced bloating and preserved ability to belch and vomit. MSA and LF both offer effective symptom relief in non-obese GERD patients. MSA demonstrates advantages in physiological function and reversibility but carries a higher risk of early dysphagia. It may be a preferred option in well-selected patients, although further randomized trials are needed to define its role as a primary surgical choice.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.030 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.011 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".