Risk of De Novo Barrett's Esophagus Post Sleeve Gastrectomy: A Systematic Review and Meta-Analysis of Studies With Long-Term Follow-Up.

Autor:	Chandan S; Center for Interventional Endoscopy, Advent Health, Orlando, Florida., Khan SR; Department of Internal Medicine, Brigham's & Women Hospital, Boston, Massachusetts., Deliwala SS; Department of Gastroenterology, Emory University, Atlanta, Georgia., Dahiya DS; Division of Gastroenterology Hepatology & Motility, The University of Kansas School of Medicine, Kansas City, Kansas., Mohan BP; Orlando Gastroenterology P.A., Orlando, Florida., Ramai D; Department of Gastroenterology, Hepatology & Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts., Saghir SM; Division of Gastroenterology and Hepatology, Creighton University School of Medicine, Omaha, Nebraska., Dhindsa BS; Department of Gastroenterology, NYU Langone Medical Center, New York, New York., Kassab LL; Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota., Facciorusso A; Gastroenterology Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy., Nandipati K; Division of Surgery, Gastroenterology, Creighton University School of Medicine, Omaha, Nebraska., Yang D; Center for Interventional Endoscopy, Advent Health, Orlando, Florida., Adler DG; Center for Advanced Therapeutic Endoscopy, Centura Health, Porter Adventist Hospital, Denver, Colorado. Electronic address: Douglas.Adler.MD@adventhealth.com.
Jazyk:	angličtina
Zdroj:	Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2025 Jan; Vol. 23 (1), pp. 33-44.e10. Date of Electronic Publication: 2024 Jul 25.
DOI:	10.1016/j.cgh.2024.06.041
Abstrakt:	Background & Aims: Sleeve gastrectomy (SG) is one of the most commonly performed bariatric procedures worldwide. Gastroesophageal reflux disease (GERD) is a major concern in patients undergoing SG and is a risk factor for Barrett's esophagus (BE). We conducted a systematic review and meta-analysis to assess the incidence of and analyze predictive factors for post-SG BE. Methods: A comprehensive literature search was conducted in April 2024, for studies reporting on incidence of BE, erosive esophagitis (EE), and hiatal hernia (HH) post-SG. Primary outcomes were post-SG pooled rates of de novo BE, EE, GERD symptoms, proton pump inhibitor use, and HH. Meta-regression analysis was performed to assess if patient and post-SG factors influenced the rates of post-SG BE. Results: Nineteen studies with 2046 patients (79% females) were included. Mean age was 42.2 years (standard deviation, 11.1) and follow-up ranged from 2 to 11.4 years. The pooled rate of de novo BE post-SG was 5.6% (confidence interval, 3.5-8.8). Significantly higher pooled rates of EE (risk ratio [RR], 3.37], HH (RR, 2.09), GER/GERD symptoms (RR, 3.32), and proton pump inhibitor use (RR, 3.65) were found among patients post-SG. GER/GERD symptoms post-SG positively influenced the pooled BE rates, whereas age, sex, body mass index, post-SG EE, and HH did not. Conclusions: Our analysis shows that SG results in a significantly increased risk of de novo BE and higher rates of EE, proton pump inhibitor use, and HH. Our findings suggest that clinicians should routinely screen patients with SG for BE and future surveillance intervals should be followed as per societal guidelines. (Copyright © 2025 AGA Institute. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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