Revisional bariatric surgery for gastroesophageal reflux disease: characterizing patient and procedural factors and 30-day outcomes for a retrospective cohort of 4412 patients.
Bariatric surgery
GERD
Revisional
Sleeve gastrectomy
Journal
Surgical endoscopy
ISSN: 1432-2218
Titre abrégé: Surg Endosc
Pays: Germany
ID NLM: 8806653
Informations de publication
Date de publication:
31 Oct 2023
31 Oct 2023
Historique:
received:
16
06
2023
accepted:
24
09
2023
medline:
1
11
2023
pubmed:
1
11
2023
entrez:
1
11
2023
Statut:
aheadofprint
Résumé
Gastroesophageal reflux disease (GERD) is a well-established potential consequence of bariatric surgery and can require revisional surgery. Our understanding of the population requiring revision is limited. In this study, we aim to characterize patients requiring revisional surgery for GERD to understand their perioperative risks and identify strategies to improve their outcomes. Using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) registry, a retrospective cohort of patients who required revisional surgery for GERD in 2020 was identified. Multivariable logistic regression modelling was used to assess correlations between baseline characteristics and morbidity. 4412 patients required revisional surgery for GERD, encompassing 24% of all conversion procedures. In most cases, patients underwent sleeve gastrectomy (SG) as their original surgery (n = 3535, 80.1%). The revisional surgery for most patients was a Roux-en-Y gastric bypass (RYGB) (n = 3722, 84.4%). Major complications occurred in 527 patients (11.9%) and 10 patients (0.23%) died within 30 days of revisional surgery. Major complications included anastomotic leak in 31 patients (0.70%) and gastrointestinal bleeding in 38 patients (0.86%). Multivariable analyses revealed that operative length, pre-operative antacid use, and RYGB were predictors of major complications. GERD is the second most common indication for revisional surgery in patients who have undergone bariatric surgery. Patients who underwent SG as their initial procedure were the primary group who required revisional surgery for GERD; most underwent revision via RYGB. Further inquiry is needed to tailor operative approaches and pre-operative optimization for revisional surgery patients.
Identifiants
pubmed: 37907658
doi: 10.1007/s00464-023-10500-4
pii: 10.1007/s00464-023-10500-4
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Courcoulas AP, Christian NJ, Belle SH, Berk PD, Flum DR, Garcia L, Horlick M, Kalarchian MA, King WC, Mitchell JE, Patterson EJ, Pender JR, Pomp A, Pories WJ, Thirlby RC, Yanovski SZ, Wolfe BM, Consortium FtLAoBS (2013) Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA 310:2416–2425
pubmed: 24189773
pmcid: 3955952
Ponce J, Nguyen NT, Hutter M, Sudan R, Morton JM (2015) American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in the United States, 2011–2014. Surg Obes Relat Dis 11:1199–1200
pubmed: 26476493
doi: 10.1016/j.soard.2015.08.496
English WJ, DeMaria EJ, Brethauer SA, Mattar SG, Rosenthal RJ, Morton JM (2018) American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016. Surg Obes Relat Dis 14:259–263
pubmed: 29370995
doi: 10.1016/j.soard.2017.12.013
Brethauer SA, Kothari S, Sudan R, Williams B, English WJ, Brengman M, Kurian M, Hutter M, Stegemann L, Kallies K, Nguyen NT, Ponce J, Morton JM (2014) Systematic review on reoperative bariatric surgery: American Society for Metabolic and Bariatric Surgery Revision Task Force. Surg Obes Relat Dis 10:952–972
pubmed: 24776071
doi: 10.1016/j.soard.2014.02.014
Pinto-Bastos A, Conceição EM, Machado PPP (2017) Reoperative bariatric surgery: a systematic review of the reasons for surgery, medical and weight loss outcomes, relevant behavioral factors. Obes Surg 27:2707–2715
pubmed: 28791623
doi: 10.1007/s11695-017-2855-7
Switzer NJ, Karmali S, Gill RS, Sherman V (2016) Revisional bariatric surgery. Surg Clin N Am 96:827–842
pubmed: 27473804
doi: 10.1016/j.suc.2016.03.004
Spyropoulos C, Kehagias I, Panagiotopoulos S, Mead N, Kalfarentzos F (2010) Revisional bariatric surgery: 13-year experience from a tertiary institution. Arch Surg 145:173–177
pubmed: 20157086
doi: 10.1001/archsurg.2009.260
Amiki M, Seki Y, Kasama K, Hashimoto K, Kitagawa M, Umezawa A, Kurokawa Y (2020) Revisional bariatric surgery for insufficient weight loss and gastroesophageal reflux disease: our 12-year experience. Obes Surg 30:1671–1678
pubmed: 31907829
doi: 10.1007/s11695-019-04374-6
Mirkin K, Alli VV, Rogers AM (2021) Revisional bariatric surgery. Surg Clin N Am 101:213–222
pubmed: 33743965
doi: 10.1016/j.suc.2020.12.008
Hjorth S, Näslund I, Andersson-Assarsson JC, Svensson PA, Jacobson P, Peltonen M, Carlsson LMS (2019) Reoperations after bariatric surgery in 26 years of follow-up of the swedish obese subjects study. JAMA Surg 154:319–326
pubmed: 30601881
pmcid: 6484798
doi: 10.1001/jamasurg.2018.5084
Chiappetta S, Lainas P, Kassir R, Valizadeh R, Bosco A, Kermansaravi M (2022) Gastroesophageal reflux disease as an indication of revisional bariatric surgery—indication and results—a systematic review and metanalysis. Obes Surg 32:3156–3171
pubmed: 35776239
doi: 10.1007/s11695-022-06183-w
Kindel TL, Oleynikov D (2016) The improvement of gastroesophageal reflux disease and Barrett’s after bariatric surgery. Obes Surg 26:718–720
pubmed: 26979967
doi: 10.1007/s11695-016-2116-1
Swann NJ, Lee WF, Aviles-Rodriguez GJ, Ramon RH, Severs T, Ajoku A, Idowu T, Yung WSE, Scharf KR (2022) Sleeve gastrectomy in patients with gastroesophageal reflux disease results in improvement or lack of progression of symptoms. J Am Coll Surg 235:S27–S28
doi: 10.1097/01.XCS.0000893104.47691.9c
Alalwan AA, Friedman J, Park H, Segal R, Brumback BA, Hartzema AG (2021) US national trends in bariatric surgery: a decade of study. Surgery 170:13–17
pubmed: 33714616
doi: 10.1016/j.surg.2021.02.002
McLennan S, Verhoeff K, Mocanu V, Jogiat U, Birch DW, Karmali S, Switzer N (2023) Characteristics and outcomes for patients undergoing revisional bariatric surgery due to persistent obesity: a retrospective cohort study of 10,716 patients. Surg Endosc 37(6):4613–4622. https://doi.org/10.1007/s00464-023-09951-6
doi: 10.1007/s00464-023-09951-6
pubmed: 36859722
Wharton S, Lau DCW, Vallis M, Sharma AM, Biertho L, Campbell-Scherer D, Adamo K, Alberga A, Bell R, Boulé N, Boyling E, Brown J, Calam B, Clarke C, Crowshoe L, Divalentino D, Forhan M, Freedhoff Y, Gagner M, Glazer S, Grand C, Green M, Hahn M, Hawa R, Henderson R, Hong D, Hung P, Janssen I, Jacklin K, Johnson-Stoklossa C, Kemp A, Kirk S, Kuk J, Langlois M-F, Lear S, McInnes A, Macklin D, Naji L, Manjoo P, Morin M-P, Nerenberg K, Patton I, Pedersen S, Pereira L, Piccinini-Vallis H, Poddar M, Poirier P, Prud’homme D, Salas XR, Rueda-Clausen C, Russell-Mayhew S, Shiau J, Sherifali D, Sievenpiper J, Sockalingam S, Taylor V, Toth E, Twells L, Tytus R, Walji S, Walker L, Wicklum S (2020) Obesity in adults: a clinical practice guideline. Can Med Assoc J 192:E875–E891
doi: 10.1503/cmaj.191707
Chiu S, Birch DW, Shi X, Sharma AM, Karmali S (2011) Effect of sleeve gastrectomy on gastroesophageal reflux disease: a systematic review. Surg Obes Relat Dis 7:510–515
pubmed: 21130052
doi: 10.1016/j.soard.2010.09.011
Parmar CD, Mahawar KK, Boyle M, Schroeder N, Balupuri S, Small PK (2017) Conversion of sleeve gastrectomy to Roux-en-Y gastric bypass is effective for gastro-oesophageal reflux disease but not for further weight loss. Obes Surg 27:1651–1658
pubmed: 28063112
doi: 10.1007/s11695-017-2542-8
Felsenreich DM, Steinlechner K, Langer FB, Vock N, Eichelter J, Bichler C, Jedamzik J, Mairinger M, Kristo I, Prager G (2022) Outcome of sleeve gastrectomy converted to Roux-en-Y gastric bypass and one-anastomosis gastric bypass. Obes Surg 32:643–651
pubmed: 35028871
pmcid: 8866292
doi: 10.1007/s11695-021-05866-0
Ashrafi D, Osland E, Memon MA (2019) Bariatric surgery and gastroesophageal reflux disease. Ann Transl Med 8:S11
doi: 10.21037/atm.2019.09.15
Altieri MS, Pryor AD (2015) Gastroesophageal reflux disease after bariatric procedures. Surg Clin N Am 95:579–591
pubmed: 25965131
doi: 10.1016/j.suc.2015.02.010
Laffin M, Chau J, Gill RS, Birch DW, Karmali S (2013) Sleeve gastrectomy and gastroesophageal reflux disease. J Obes 2013:741097
pubmed: 23956846
pmcid: 3727177
doi: 10.1155/2013/741097
Stenard F, Iannelli A (2015) Laparoscopic sleeve gastrectomy and gastroesophageal reflux. World J Gastroenterol 21:10348–10357
pubmed: 26420961
pmcid: 4579881
doi: 10.3748/wjg.v21.i36.10348
Peng B-q, Zhang G-x, Chen G, Cheng Z, Hu J-k, Du X (2020) Gastroesophageal reflux disease complicating laparoscopic sleeve gastrectomy: current knowledge and surgical therapies. Surg Obes Relat Dis 16:1145–1155
pubmed: 32576511
doi: 10.1016/j.soard.2020.04.025
Pavone G, Tartaglia N, Porfido A, Panzera P, Pacilli M, Ambrosi A (2022) The new onset of GERD after sleeve gastrectomy: a systematic review. Ann Med Surg 77:103584
doi: 10.1016/j.amsu.2022.103584
Sheppard CE, Sadowski DC, de Gara CJ, Karmali S, Birch DW (2015) Rates of reflux before and after laparoscopic sleeve gastrectomy for severe obesity. Obes Surg 25:763–768
pubmed: 25411120
doi: 10.1007/s11695-014-1480-y
Yeung KTD, Penney N, Ashrafian L, Darzi A, Ashrafian H (2020) Does sleeve gastrectomy expose the distal esophagus to severe reflux? A systematic review and meta-analysis. Ann Surg 271:257–265
pubmed: 30921053
doi: 10.1097/SLA.0000000000003275
Himpens J, Dapri G, Cadière GB (2006) A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg 16:1450–1456
pubmed: 17132410
doi: 10.1381/096089206778869933
Braghetto I, Lanzarini E, Korn O, Valladares H, Molina JC, Henriquez A (2010) Manometric changes of the lower esophageal sphincter after sleeve gastrectomy in obese patients. Obes Surg 20:357–362
pubmed: 20013071
doi: 10.1007/s11695-009-0040-3
Yehoshua RT, Eidelman LA, Stein M, Fichman S, Mazor A, Chen J, Bernstine H, Singer P, Dickman R, Beglaibter N, Shikora SA, Rosenthal RJ, Rubin M (2008) Laparoscopic sleeve gastrectomy—volume and pressure assessment. Obes Surg 18:1083–1088
pubmed: 18535864
doi: 10.1007/s11695-008-9576-x
Nahata M, Muto S, Oridate N, Ohnishi S, Nakagawa K, Sadakane C, Saegusa Y, Hattori T, Asaka M, Takeda H (2012) Impaired ghrelin signaling is associated with gastrointestinal dysmotility in rats with gastroesophageal reflux disease. Am J Physiol Gastrointest Liver Physiol 303:G42-53
pubmed: 22517773
pmcid: 3404573
doi: 10.1152/ajpgi.00462.2011
Melissas J, Leventi A, Klinaki I, Perisinakis K, Koukouraki S, de Bree E, Karkavitsas N (2013) Alterations of global gastrointestinal motility after sleeve gastrectomy: a prospective study. Ann Surg 258:976–982
pubmed: 23160151
doi: 10.1097/SLA.0b013e3182774522
Pandolfino JE, Kim H, Ghosh SK, Clarke JO, Zhang Q, Kahrilas PJ (2007) High-resolution manometry of the EGJ: an analysis of crural diaphragm function in GERD. Am J Gastroenterol 102:1056–1063
pubmed: 17319930
doi: 10.1111/j.1572-0241.2007.01138.x
Karamanakos SN, Vagenas K, Kalfarentzos F, Alexandrides TK (2008) Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and peptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy: a prospective, double blind study. Ann Surg 247:401–407
pubmed: 18376181
doi: 10.1097/SLA.0b013e318156f012
DuPree CE, Blair K, Steele SR, Martin MJ (2014) Laparoscopic sleeve gastrectomy in patients with preexisting gastroesophageal reflux disease: a national analysis. JAMA Surg 149:328–334
pubmed: 24500799
doi: 10.1001/jamasurg.2013.4323
Thereaux J, Lesuffleur T, Czernichow S, Basdevant A, Msika S, Nocca D, Millat B, Fagot-Campagna A (2017) Do sleeve gastrectomy and gastric bypass influence treatment with proton pump inhibitors 4 years after surgery? A nationwide cohort. Surg Obes Relat Dis 13:951–959
pubmed: 28223087
doi: 10.1016/j.soard.2016.12.013
Barr AC, Frelich MJ, Bosler ME, Goldblatt MI, Gould JC (2017) GERD and acid reduction medication use following gastric bypass and sleeve gastrectomy. Surg Endosc 31:410–415
pubmed: 27287901
doi: 10.1007/s00464-016-4989-4
WuChaoYing V, Kim SH, Khan K, Farrokhyar F, D’souza J, Gmora S, Anvari M, Hong D (2015) Prophylactic PPI help reduce marginal ulcers after gastric bypass surgery: a systematic review and meta-analysis of cohort studies. Surg Endosc 29:1018–1023
doi: 10.1007/s00464-014-3794-1
Del Genio G, Tolone S, Limongelli P, Brusciano L, D’Alessandro A, Docimo G, Rossetti G, Silecchia G, Iannelli A, del Genio A, del Genio F, Docimo L (2014) Sleeve gastrectomy and development of “de novo” gastroesophageal reflux. Obes Surg 24:71–77
doi: 10.1007/s11695-013-1046-4
Sheppard CE (2017) Gastroesophageal motility and reflux following bariatric surgery for the treatment of severe obesity. PhD thesis, University of Alberta, Edmonton, Alberta
Matar R, Maselli D, Vargas E, Veeravich J, Bazerbachi F, Beran A, Storm AC, Kellogg T, Abu Dayyeh BK (2020) Esophagitis after bariatric surgery: large cross-sectional assessment of an endoscopic database. Obes Surg 30:161–168
pubmed: 31584148
doi: 10.1007/s11695-019-04164-0
Indja B, Chan DL, Talbot ML (2022) Hiatal reconstruction is safe and effective for control of reflux after laparoscopic sleeve gastrectomy. BMC Surg 22:347
pmcid: 9490990
doi: 10.1186/s12893-022-01800-y
Surve A, Rao R, Cottam D, Rao A, Ide L, Cottam S, Horsley B (2020) Early outcomes of primary SADI-S: an Australian experience. Obes Surg 30:1429–1436
pubmed: 31925728
doi: 10.1007/s11695-019-04312-6
Fayad L, Adam A, Schweitzer M, Cheskin LJ, Ajayi T, Dunlap M, Badurdeen DS, Hill C, Paranji N, Lalezari S, Kalloo AN, Khashab MA, Kumbhari V (2019) Endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy: a case-matched study. Gastrointest Endosc 89:782–788
pubmed: 30148991
doi: 10.1016/j.gie.2018.08.030
Lee A, Broderick R, Cheverie J, Sandler B, Jacobsen G, Horgan S (2019) A641 less is more: avoiding conversion to RYGB with LINX placement after sleeve gastrectomy. Surg Obes Relat Dis 15:S261–S262
doi: 10.1016/j.soard.2019.09.027
Reames BN, Bacal D, Krell RW, Birkmeyer JD, Birkmeyer NJO, Finks JF (2015) Influence of median surgeon operative duration on adverse outcomes in bariatric surgery. Surg Obes Relat Dis 11:207–213
pubmed: 25066438
doi: 10.1016/j.soard.2014.03.018
Clapp B, Marrero K, Corbett J, Sharma I, Hage K, Vierkant RA, McKenzie T, Davis SS, Ghanem OM (2023) Effect of operative times in bariatric surgery on outcomes: a matched analysis of the MBSAQIP database. Surg Endosc 37:4113–4122
pubmed: 36752855
doi: 10.1007/s00464-023-09927-6
Skulsky SL, Dang JT, Switzer NJ, Sharma AM, Karmali S, Birch DW (2021) Higher Edmonton Obesity Staging System scores are independently associated with postoperative complications and mortality following bariatric surgery: an analysis of the MBSAQIP. Surg Endosc 35:7163–7173
pubmed: 33155074
doi: 10.1007/s00464-020-08138-7
Stenberg E, Dos Reis Falcão LF, O’Kane M, Liem R, Pournaras DJ, Salminen P, Urman RD, Wadhwa A, Gustafsson UO, Thorell A (2022) Guidelines for perioperative care in bariatric surgery: Enhanced Recovery After Surgery (ERAS) Society recommendations: a 2021 update. World J Surg 46:729–751
pubmed: 34984504
pmcid: 8885505
doi: 10.1007/s00268-021-06394-9
Trotta M, Ferrari C, D’Alessandro G, Sarra G, Piscitelli G, Marinari GM (2019) Enhanced recovery after bariatric surgery (ERABS) in a high-volume bariatric center. Surg Obes Relat Dis 15:1785–1792
pubmed: 31519490
doi: 10.1016/j.soard.2019.06.038
Matar R, Monzer N, Jaruvongvanich V, Abusaleh R, Vargas EJ, Maselli DB, Beran A, Kellogg T, Ghanem O, Abu Dayyeh BK (2021) Indications and outcomes of conversion of sleeve gastrectomy to Roux-en-Y gastric bypass: a systematic review and a meta-analysis. Obes Surg 31:3936–3946
pubmed: 34218416
doi: 10.1007/s11695-021-05463-1
El-Hadi M, Birch DW, Gill RS, Karmali S (2014) The effect of bariatric surgery on gastroesophageal reflux disease. Can J Surg 57:139–144
pubmed: 24666452
pmcid: 3968207
doi: 10.1503/cjs.030612
Suter M (2020) Gastroesophageal reflux disease, obesity, and Roux-en-Y gastric bypass: complex relationship—a narrative review. Obes Surg 30:3178–3187
pubmed: 32424794
doi: 10.1007/s11695-020-04690-2
Siilin H, Wanders A, Gustavsson S, Sundbom M (2005) The proximal gastric pouch invariably contains acid-producing parietal cells in Roux-en-Y gastric bypass. Obes Surg 15:771–777
pubmed: 15978145
doi: 10.1381/0960892054222849
Swartz DE, Mobley E, Felix EL (2009) Bile reflux after Roux-en-Y gastric bypass: an unrecognized cause of postoperative pain. Surg Obes Relat Dis 5:27–30
pubmed: 19095503
doi: 10.1016/j.soard.2008.10.009
Chen RH, Lautz D, Gilbert RJ, Bueno R (2005) Antireflux operation for gastroesophageal reflux after Roux-en-y gastric bypass for obesity. Ann Thorac Surg 80:1938–1940
pubmed: 16242496
doi: 10.1016/j.athoracsur.2004.06.019
Kawahara NT, Alster C, Maluf-Filho F, Polara W, Campos GM, Poli-de-Figueiredo LF (2012) Modified Nissen fundoplication: laparoscopic antireflux surgery after Roux-en-Y gastric bypass for obesity. Clinics 67:531–533
pubmed: 22666803
pmcid: 3351257
doi: 10.6061/clinics/2012(05)23
Colpaert J, Horevoets J, Maes L, Uijtterhaegen G, Dillemans B (2020) Surgical treatment of therapy-resistant reflux after Roux-en-Y gastric bypass. A case series of the modified Nissen fundoplication. Acta Chir Belg 120:291–296
pubmed: 31746675
doi: 10.1080/00015458.2019.1696028
Vorwald P, Restrepo Núñez RM, Salcedo Cabañas G, Posada González M (2019) Laparoscopic Toupet fundoplication after Roux-en-Y gastric bypass in patient with severe GERD. Obes Surg 29:1432
pubmed: 30725433
doi: 10.1007/s11695-018-03691-6
Pescarus R, Sharata AM, Dunst CM, Shlomovitz E, Swanström LL, Reavis KM (2016) Hill procedure for recurrent GERD post-Roux-en-Y gastric bypass. Surg Endosc 30:2141
pubmed: 26335068
doi: 10.1007/s00464-015-4442-0
Mattar S, Qureshi F, Taylor D, Schauer P (2006) Treatment of refractory gastroesophageal reflux disease with radiofrequency energy (Stretta) in patients after Roux-en-Y gastric bypass. Surg Endosc Other Interv Tech 20:850–854
doi: 10.1007/s00464-006-0513-6
Hefler J, Dang J, Mocanu V, Switzer N, Birch DW, Karmali S (2019) Concurrent bariatric surgery and paraesophageal hernia repair: an analysis of the Metabolic and Bariatric Surgery Association Quality Improvement Program (MBSAQIP) database. Surg Obes Relat Dis 15:1746–1754
pubmed: 31588008
doi: 10.1016/j.soard.2019.08.025
Verhoeff K, Mocanu V, Dang J, Wilson H, Switzer NJ, Birch DW, Karmali S (2022) Effect of the COVID-19 pandemic on bariatric surgery in North America: a retrospective analysis of 834,647 patients. Surg Obes Relat Dis 18:803–811
pubmed: 35474010
pmcid: 8933967
doi: 10.1016/j.soard.2022.03.012
Campos GM, Mazzini GS, Altieri MS, Docimo S, DeMaria EJ, Rogers AM (2021) ASMBS position statement on the rationale for performance of upper gastrointestinal endoscopy before and after metabolic and bariatric surgery. Surg Obes Relat Dis 17:837–847
pubmed: 33875361
doi: 10.1016/j.soard.2021.03.007
Felsenreich DM, Langer FB, Bichler C, Eilenberg M, Jedamzik J, Kristo I, Vock N, Gensthaler L, Rabl C, Todoroff A, Prager G (2020) Roux-en-Y gastric bypass as a treatment for Barrett’s esophagus after sleeve gastrectomy. Obes Surg 30:1273–1279
pubmed: 31808119
doi: 10.1007/s11695-019-04292-7