Does Sleeve Gastrectomy Worsen Gastroesophageal Reflux Disease in Obese Patients? A Prospective Study.
24h-pH-impedance
bariatric surgery
gastroesophageal reflux disease (GERD)
laparoscopic gastric bypass
laparoscopic sleeve gastrectomy
manometry
pH-manometry
Journal
Surgical innovation
ISSN: 1553-3514
Titre abrégé: Surg Innov
Pays: United States
ID NLM: 101233809
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
pubmed:
7
12
2021
medline:
29
10
2022
entrez:
6
12
2021
Statut:
ppublish
Résumé
To evaluate the impact of laparoscopic sleeve gastrectomy (LSG) and gastric bypass (LGB) on gastroesophageal reflux disease (GERD). GERD was evaluated by the Modified Italian Gastroesophageal reflux disease-Health-Related Quality of Life (MI-GERD-HRQL) questionnaire, pH-manometry, endoscopy, and Rx-esophagogram, before and 12 months after surgery. Based on these exams, patients without GERD underwent LSG, and patients with GERD underwent LGB. Thirteen and six patients underwent LSG and LGB, respectively. After LSG, the only statistically significant difference observed at pH-manometry was the median DeMeester score, from 5.7 to 22.7 (P = .0026). LSG has a negative impact on GERD, even in patients without preoperative GERD. LGB confirmed to be the intervention of choice in patients with GERD. Preoperative pH-manometry may identify patients with silent GERD, to candidate them to LGB rather than LSG. pH-manometry should be used more liberally to establish the correct surgical indication on objective grounds.
Sections du résumé
BACKGROUND
BACKGROUND
To evaluate the impact of laparoscopic sleeve gastrectomy (LSG) and gastric bypass (LGB) on gastroesophageal reflux disease (GERD).
METHODS
METHODS
GERD was evaluated by the Modified Italian Gastroesophageal reflux disease-Health-Related Quality of Life (MI-GERD-HRQL) questionnaire, pH-manometry, endoscopy, and Rx-esophagogram, before and 12 months after surgery. Based on these exams, patients without GERD underwent LSG, and patients with GERD underwent LGB.
RESULTS
RESULTS
Thirteen and six patients underwent LSG and LGB, respectively. After LSG, the only statistically significant difference observed at pH-manometry was the median DeMeester score, from 5.7 to 22.7 (P = .0026).
CONCLUSIONS
CONCLUSIONS
LSG has a negative impact on GERD, even in patients without preoperative GERD. LGB confirmed to be the intervention of choice in patients with GERD. Preoperative pH-manometry may identify patients with silent GERD, to candidate them to LGB rather than LSG. pH-manometry should be used more liberally to establish the correct surgical indication on objective grounds.
Identifiants
pubmed: 34865557
doi: 10.1177/15533506211052745
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM