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The aim of this study was to evaluate postoperative dysphagia rates, its risk factors, and management after MSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From a prospectively collected database of all 357 patients that underwent MSA at our institution, a total of 268 patients were included in our retrospective study. Postoperative dysphagia score, gastrointestinal symptoms, proton pump inhibitor intake, GERD\u2010HRQL, Alimentary Satisfaction, and serial contrast swallow imaging were evaluated within standardized follow\u2010up appointments. To determine patients\u2019 characteristics and surgical factors associated with postoperative dysphagia, a multivariable logistic regression analysis was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At a median follow\u2010up of 23\u00a0months, none of the patients presented with severe dysphagia, defined as the inability to swallow solids or\/and liquids. 1% of the patients underwent endoscopic dilatation, and 1% had been treated conservatively for dysphagia. 2% of the patients needed re\u2010operation, most commonly due to recurrent hiatal hernia. Two patients underwent device removal due to unspecific discomfort and pain. No migration of the device or erosion by the device was seen. The LINX\u00ae device size\u2009\u2264\u200913 was found to be the only factor associated with postoperative dysphagia (OR 5.90 (95% CI 1.4\u201324.8)). The postoperative total GERD\u2010HRQL score was significantly lower than preoperative total score (2 vs. 19; <jats:italic>p<\/jats:italic>\u2009=\u20090.001), and daily heartburn, regurgitations, and respiratory complains improved in 228\/241 (95%), 131\/138 (95%) and 92\/97 (95%) of patients, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Dysphagia requiring endoscopic or surgical intervention was rare after MSA in a large case series. LINX\u00ae devices with a size\u2009&lt;\u200913 were shown to be an independent risk factor for developing postoperative dysphagia.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-022-06573-2","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T13:18:28Z","timestamp":1651238308000},"page":"2243-2250","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Severe Dysphagia is Rare After Magnetic Sphincter Augmentation"],"prefix":"10.1002","volume":"46","author":[{"given":"Milena","family":"Bologheanu","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of General Surgery Medical University of Vienna Waehringer Guertel 18\u201020 1090 Vienna Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksa","family":"Matic","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of General Surgery Medical University of 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