Impact of laparoscopic sleeve gastrectomy on esophageal physiology
| Autor: | Raluca-Simona Costache, Vasile Daniel Balaban, Florentina Ioniţă-Radu, A Popescu, Mariana Jinga, Florin Săvulescu, Carmen Fierbinţeanu-Braticevici |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male obesity medicine.medical_specialty Sleeve gastrectomy medicine.drug_class medicine.medical_treatment esophageal dysmotility Proton-pump inhibitor Gastroenterology Body Mass Index 03 medical and health sciences 0302 clinical medicine Weight loss Gastrectomy Internal medicine Weight Loss otorhinolaryngologic diseases medicine Prevalence Esophagitis Humans Prospective Studies Aged business.industry Reflux Middle Aged medicine.disease RC31-1245 Obesity Morbid 030220 oncology & carcinogenesis GERD Gastroesophageal Reflux 030211 gastroenterology & hepatology Female Laparoscopy medicine.symptom business Weight Loss Surgery Body mass index sleeve gastrectomy |
| Zdroj: | Romanian Journal of Internal Medicine, Vol 59, Iss 3, Pp 296-302 (2021) |
| ISSN: | 2501-062X |
| Popis: | Introduction. Laparoscopic sleeve gastrectomy (LSG) is a popular weight loss surgery technique, but the impact on esophageal physiology and esophagogastric junction is still debatable. The aim of our study was to evaluate the manometric changes of the lower esophageal sphincter (LES) after LSG in order to indicate LES manometry pre- procedure. Methods. In a prospective study we evaluated clinically, with upper gastrointestinal endoscopy, and high-resolution esophageal manometry 45 morbidly obese patients before, and 6–12 months after LSG. Results. The BMI (body mass index) decreased from 46.28±5.79 kg/m2 to 32.28±4.65 kg/m2 postoperatively (p 2 of BMI, 39.9 (±11.9) kg body weight and 29.9 (± 6.2)% of the TWL (Total Weight Loss index), in a median interval of 7.9 months. Gastroesophageal reflux disease (GERD) prevalence increased from 17.8% to 31.1% postoperatively, with new GERD onset in 22.2%, but mild symptomatology (the median GERD-HRQL score increased from 1.56 to 2.84 points). Postoperatory reflux was associated with lower esophageal sphincter (LES) hypotonia, shortening of LES length and IIGP (increased intragastric pressure). Hiatal hernia repair rate was 17.8%, and proton pump inhibitor consumption 20%. After weight loss, the 10 cases of esophagitis discovered preoperatively cured, but 3 patients were diagnosed with de novo esophagitis. The prevalence of manometric dysmotility after LSG was 28.9%, lower than before surgery (44.4%). Conclusion. Even if GERD remains the main limitation of LSG, the high-resolution esophageal manometry has proved useful and should be implemented in morbidly obese evaluation protocol, to better select the bariatric procedure. |
| Databáze: | OpenAIRE |
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