Sleeve gastrectomy and gastroesophageal reflux: a comprehensive endoscopic and pH-manometric prospective study
| Autor: | Annamaria Pronio, Giovanni Casella, Lidia Castagneto-Gissey, Alfredo Genco, Danilo Badiali, Giulia Del Corpo |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Sleeve gastrectomy Manometry medicine.medical_treatment 030209 endocrinology & metabolism Gastroesophageal reflux disease Endoscopy High-resolution manometry 24-hour pH monitoring Gastroenterology Hiatal hernia 03 medical and health sciences 0302 clinical medicine Gastrectomy Internal medicine medicine Humans Prospective Studies Prospective cohort study High resolution manometry medicine.diagnostic_test Esophagogastroduodenoscopy business.industry Reflux Hydrogen-Ion Concentration medicine.disease Obesity Morbid Surgery Italy Barrett's esophagus Gastroesophageal Reflux Quality of Life GERD 030211 gastroenterology & hepatology business |
| Zdroj: | Surgery for Obesity and Related Diseases. 16:1629-1637 |
| ISSN: | 1550-7289 |
| Popis: | Background The impact of sleeve gastrectomy (SG) on gastroesophageal reflux disease (GERD) is still greatly debated. Most of the current evidence available is solely based on symptom evaluation or medication use, while a minority have implemented objective functional measurements. Objective To better comprehend the pathophysiological mechanisms involved in the genesis of GERD after SG. Setting University Hospital, Italy. Methods A total of 21 patients affected by morbid obesity and eligible for SG were prospectively enrolled in the present study. Patients were evaluated by means of endoscopy, high-resolution manometry (HRM), 24-hour pH monitoring, and the Gastroesophageal Reflux Disease Health-Related Quality of Life questionnaire. Results Follow-up was completed at least 1 year post operation (mean follow-up, 14.3 ± 2.1 mo) by 19 patients. Body mass index decreased from 41.2 ± .9 to 26.8 ± .8 kg/m2 (P Conclusions Postoperative GERD-related esophageal sequelae should be carefully considered after SG. Our results demonstrate how acid reflux does not seem to play a relevant role in the pathophysiology of post-SG GERD. Baseline HRM can help stratify the risk of developing erosive esophagitis and Z-line upward migration after SG, while postoperative endoscopic surveillance should be encouraged regardless of the presence or absence of symptoms. |
| Databáze: | OpenAIRE |
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