The Impact of Sleeve Gastrectomy on Gastroesophageal Reflux Disease in Patients with Morbid Obesity.

Autor: Sancho Moya, Cristina, Bruna Esteban, Marcos, Sempere García-Argüelles, Javier, Ferrer Barceló, Luis, Monzó Gallego, Ana, Mirabet Sáez, Beatriz, Mulas Fernández, Claudia, Albors Bagá, Pilar, Vázquez Prado, Antonio, Oviedo Bravo, Miguel, Montalvá Orón, Eva
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Zdroj: Obesity Surgery; Mar2022, Vol. 32 Issue 3, p615-624, 10p
Abstrakt: Introduction: The impact of laparoscopic sleeve gastrectomy (LSG) on gastroesophageal reflux disease (GERD) has not been widely quantified, and the data in the literature remain controversial. Materials and Methods: Candidates for LSG underwent barium swallow, esophageal manometry, ambulatory 24-h esophageal pH monitoring (APM), and gastric emptying scintigraphy before and after surgery (1 and 18 months). Symptoms were evaluated using a gastroesophageal reflux disease questionnaire (GERDq). Esophagogastroduodenoscopy was performed preoperatively in all patients and at 18 months postoperatively in patients who had suffered from preoperative esophagitis. Results: Fifty-two patients were included in the study (64.4% women and 34.6% men) with a median age of 46 years (25–63 years) and BMI of 45.0 ± 5.6 kg/m2. The follow-up rates at 1 and 18 months were 82.7% and 80.8%. At 18 months, the percentage of weight loss (%TWL) was 33.6 ± 10.4% and the percentage of excess BMI loss (%EBMIL) was 77.6 ± 25%. Postoperatively, a significant increase in accelerated gastric emptying and impaired esophageal body motility occurred at 1 and 18 months. A significant worsening of all the values obtained at both 1 and 18 months postoperatively becomes evident when comparing the results of the APM. After surgery, 76.4% of patients had developed "de novo" GERD at 1 month and 41% at 18 months. No improvement was found in patients with symptomatic GERD. Conclusion: Based on the results of this study, LSG led to a considerable rate of postoperative "de novo" GERD. In addition, no improvement was found in patients with symptomatic GERD. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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