Comment on: Acid and non-acid gastroesophageal reflux after single anastomosis gastric bypass.
Comment on: Acid and non-acid gastroesophageal reflux after single anastomosis gastric bypass. Surg Obes Relat Dis. 2018 Sep;14(9):1419-1420 Authors: Deitel M, Rheinwalt KP, Musella M, Weiner R, Kular KS, Peraglia C, Prasad A, Luciani RC, Sakran N, Plamper A PMID: 30268322 [PubMed - in process]
ConclusionsRYGB is an effective therapy for patients with BE and reflux after SG. Its outcomes in the current study were BE remission in the majority of cases as well as a decrease in reflux activity. Further studies with larger cohorts are necessary to confirm these findings.
ConclusionOAGB is more effective for %EWL and dyslipidemia remission than SG. In addition, OAGB may lower the risk of postoperative leak, gastroesophageal reflux disease, revision, and mortality. Further comparisons of the clinical outcomes of OAGB versus SG for morbid obesity would benefit from more high-quality controlled studies.
AbstractIntroductionSleeve gastrectomy (SG) has overtaken Roux-En-Y gastric bypass (RYGB) as the most common bariatric procedure worldwide. However, there is little long-term data comparing the two procedures.ObjectivesWe perform a systematic review and meta-analysis comparing 5-year outcomes of randomised controlled trials (RCTs) comparing RYGB and SG.MethodsMedline, Embase, The Cochrane Library, and NHS Evidence were searched for English language RCTs comparing RYGB with SG and assessed weight loss and/or comorbidity resolution at 5 years.ResultsFive studies were included in the final analysis. Meta-analysis demonstrates...
AbstractThe purpose of this study was to investigate the relationship between bariatric surgery (laparoscopic sleeve gastrectomy [LSG] and laparoscopic Roux-en-Y gastric bypass [LRYGB]) and gastroesophageal reflux disease (GERD). The number of obese patients with newly onset, worsened, or improved GERD after bariatric surgery in each article were extracted. In the pooled analysis, LSG was associated with a higher risk of GERD than LRYGB (odds ratio [OR] = 5.10, 95% confidence interval [CI] 3.60 –7.23,p
AbstractIntroductionBariatric surgery is increasingly performed. Since there are numerous surgical techniques, the effects of these on the esophageal function are still poorly understood. We aimed at assessing the effect of different techniques on esophagogastric junction (EGJ), esophageal peristalsis and reflux exposure using high-resolution manometry (HRM), and impedance-pH monitoring (MII-pH).MethodsAll obese patients underwent symptomatic questionnaires, endoscopy, HRM, and MII-pH before and 1 year after surgery. Esophageal function and EGJ were classified according to Chicago Classification V. 3.0. Intragastric ...
ConclusionEE is more prevalent after SG compared with RYGB in a pre-bariatric surgery cohort with GERD. SG is associated with significant esophageal physiologic changes conducive to GERD and its clinical consequences.
Gastroesophageal reflux can improve or worsen after bariatric surgery depending on procedure type. Our goal was to compare patient reported symptoms of reflux after gastric bypass (GB) and sleeve gastrectomy (SG) based on preoperative symptom severity.
Laparoscopic sleeve gastrectomy (LSG) is a commonly performed bariatric procedure in obesity management. Gastroesophageal reflux disease (GERD) in this population has reported rates of 23-100% GERD after LSG . GERD after LSG has been noted with recent studies demonstrating de novo reflux or symptom exacerbation despite weight loss. Fundoplication is not an option, and medically refractory GERD after LSG is usually treated with conversion to Roux-en-Y gastric bypass (RYGB). This video demonstrates the placement of a magnetic sphincter augmentation device after LSG as an alternative to conversion to RYGB.
We present a video of a 42-year old female who underwent laparoscopic MSA placement for the treatment of GERD after prior Roux-en-Y gastric bypass (RYGB) for morbid obesity. The patient had an initial body mass index of 35.8 kg/m2 and underwent a RYGB in 2006. She developed dumping syndrome treated with sclerotherapy of the gastro-jejunal anastomosis in 2009.
Gastroesophageal reflux disease (GERD) is common in patients with obesity and different bariatric procedures have different effects on the symptoms. There is little long-term data regarding acid suppression therapy (AST: proton pump inhibitor or H2-blocker) use after bariatric surgery.