Reduced risk of de novo Barrett esophagus after bariatric surgery: a national database study.

Autor:	Hurtado A; Case Western Reserve University School of Medicine, Cleveland, Ohio. Electronic address: amh312@case.edu., Chandar AK; Case Western Reserve University School of Medicine, Cleveland, Ohio; University Hospitals Cleveland Medical Center, Cleveland, Ohio., Perez JA; University Hospitals Cleveland Medical Center, Cleveland, Ohio., Casselberry R; University Hospitals Cleveland Medical Center, Cleveland, Ohio., Martin SA; University Hospitals Cleveland Medical Center, Cleveland, Ohio., DeLano K; TriNetX, LLC, Cambridge, Massachusetts., Abbas M; University Hospitals Cleveland Medical Center, Cleveland, Ohio., Chak A; Case Western Reserve University School of Medicine, Cleveland, Ohio; University Hospitals Cleveland Medical Center, Cleveland, Ohio.
Jazyk:	angličtina
Zdroj:	Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery [Surg Obes Relat Dis] 2024 Jan; Vol. 20 (1), pp. 40-45. Date of Electronic Publication: 2023 Aug 18.
DOI:	10.1016/j.soard.2023.08.009
Abstrakt:	Background: Bariatric surgery is an effective treatment for obesity and may decrease the morbidity and mortality of obesity-associated cancers. Objective: We investigated the risk of a new diagnosis of Barrett esophagus (BE) following bariatric surgery compared to screening colonoscopy controls. Setting: Large national database including patients who received care in inpatient, outpatient, and specialty care services. Methods: A national healthcare database (TriNetX, LLC) was used for this analysis. Cases included adults (aged ≥18 yr) who had undergone either sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). Controls included adults undergoing screening colonoscopy and an esophagoduodenoscopy on the same day and had never undergone bariatric surgery. Cases and controls were propensity-matched for confounders. The risk of de novo diagnosis of BE at least 1 year after bariatric surgery was compared between cases and controls. Secondary analyses examined the effect of bariatric surgery on metabolic outcomes such as weight loss and body mass index (BMI). The risk of de novo diagnosis of BE in SG was compared with RYGB. Odds ratios (OR) and 95% CI were used to report on these associations. Results: In the propensity-matched analysis, patients who had undergone a bariatric surgical procedure showed a significantly reduced risk of de novo BE when compared with screening colonoscopy controls (.67 [.48, .94]). There was substantial reduction in weight and BMI in the bariatric surgery group when compared with baseline. There was no significant difference in de novo BE diagnosis between the propensity-matched SG and RYGB groups (.77 [.5, 1.2]). Conclusion: Patients who underwent bariatric surgery (RYGB or SG) had a lower risk of being diagnosed with BE compared with screening colonoscopy controls who did not receive bariatric surgery. This effect appears to be largely mediated by reduction in weight and BMI. (Copyright © 2024 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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