One Anastomosis Gastric Bypass in Patients with Gastrooesophageal Reflux Disease and/or Hiatus Hernia
| Autor: | Kamal Mahawar, Joseph Winstanley, Miraheal Adadzewa Sam, Michael J. Courtney, Salman Ahmed |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism Gastric bypass Gastric Bypass 030209 endocrinology & metabolism Anastomosis Medium term 03 medical and health sciences 0302 clinical medicine Weight loss Gastrooesophageal reflux disease medicine Humans In patient Hernia Prospective Studies Retrospective Studies Nutrition and Dietetics medicine.diagnostic_test business.industry digestive oral and skin physiology medicine.disease humanities digestive system diseases Surgery Endoscopy Obesity Morbid Hernia Hiatal Gastroesophageal Reflux 030211 gastroenterology & hepatology medicine.symptom business |
| Zdroj: | Obesity surgery. 31(4) |
| ISSN: | 1708-0428 |
| Popis: | One anastomosis gastric bypass (OAGB) offers favourable weight loss outcomes and is associated with reduced morbidity and mortality when compared to other mainstream bariatric procedures. However, a randomised trial reported a conversion rate to roux-en-Y configuration (RYC) of 3.1%, and some surgeons consider the procedure unsuitable for patients with a preoperative hiatus hernia (HH) or symptoms of gastrooesophageal reflux disease (GORD). We carried out a retrospective review of patients undergoing OAGB in our institution. Included were all patients on PPI for symptoms of GORD preoperatively, as well as patients with HH or oesophagitis on preoperative endoscopy. We recorded GORD outcomes as well as rates of conversion to RYC in patients. Medium term follow up data at 23–28 months was available for 89 patients. Of these, 63 had HH, 34 had preoperative GORD requiring PPI and 9 had confirmed oesophagitis. The conversion rate to RYC was nil (0/63) in patients with HH. At the same time, 14.7% (5/34) of patients with preop GORD on PPI required conversion to RYC at a median time interval of 16 months. In patients already on PPI preoperatively, 16/34 (47.1%) needed to continue on PPI long term. In patients with HH, 20.6% (13/63) suffered de novo GORD symptoms. OAGB can be offered to patients with HH with acceptable GORD outcomes but caution is advised in patients with preoperative GORD symptoms. Larger prospective and randomised studies are required to further assess this subgroup. |
| Databáze: | OpenAIRE |
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