Magnetic Sphincter Augmentation Versus Fundoplication in Non-obese Gastroesophageal Reflux Disease (GERD) Patients: A Systematic Review of Patient-Reported Outcomes and Dysphagia
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.…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,598 participants or records.
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