Long-term outcomes of Roux-en-Y gastric diversion after failed surgical fundoplication in a large cohort and a systematic review.
Dysphagia
Fundoplication
Gastroesophageal reflux disease
Roux-en-Y gastric diversion
Journal
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
29
05
2020
revised:
03
08
2020
accepted:
09
08
2020
pubmed:
10
10
2020
medline:
25
5
2021
entrez:
9
10
2020
Statut:
ppublish
Résumé
Roux-en-Y gastric diversion (RNYG) is an alternative approach for patients with persistent or recurrent gastroesophageal reflux disease (GERD) after surgical fundoplication, especially in patients with esophageal dysmotility or morbid obesity, because redo fundoplication could offer unfavorable outcomes. To evaluate long-term outcomes of RNYG for failed fundoplication and its impact on esophageal function. A retrospective cohort study and a systematic review. Patients who underwent RNYG after failed fundoplication between 1995 and 2019 were identified. Surgical-related complications, GERD, dysphagia, and endoscopic and esophageal manometric findings were reviewed. A literature search for relevant studies was performed from several databases from database inception to September 2019. A total of 101 patients (mean age, 52.1 yr; 86.1% female; mean body mass index, 35.8 kg/m RNYG is an effective alternative surgery in a subset of patients with intractable symptoms who failed fundoplication. However, patients should be informed of the risks of postoperative GERD symptoms and dysphagia. Referral for a careful evaluation by a multidisciplinary foregut team is warranted.
Sections du résumé
BACKGROUND
BACKGROUND
Roux-en-Y gastric diversion (RNYG) is an alternative approach for patients with persistent or recurrent gastroesophageal reflux disease (GERD) after surgical fundoplication, especially in patients with esophageal dysmotility or morbid obesity, because redo fundoplication could offer unfavorable outcomes.
OBJECTIVE
OBJECTIVE
To evaluate long-term outcomes of RNYG for failed fundoplication and its impact on esophageal function.
SETTING
METHODS
A retrospective cohort study and a systematic review.
METHODS
METHODS
Patients who underwent RNYG after failed fundoplication between 1995 and 2019 were identified. Surgical-related complications, GERD, dysphagia, and endoscopic and esophageal manometric findings were reviewed. A literature search for relevant studies was performed from several databases from database inception to September 2019.
RESULTS
RESULTS
A total of 101 patients (mean age, 52.1 yr; 86.1% female; mean body mass index, 35.8 kg/m
CONCLUSION
CONCLUSIONS
RNYG is an effective alternative surgery in a subset of patients with intractable symptoms who failed fundoplication. However, patients should be informed of the risks of postoperative GERD symptoms and dysphagia. Referral for a careful evaluation by a multidisciplinary foregut team is warranted.
Identifiants
pubmed: 33032918
pii: S1550-7289(20)30480-9
doi: 10.1016/j.soard.2020.08.015
pii:
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
161-169Informations de copyright
Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.