Comment on: Predictive value of preoperative DeMeester score on conversion to Roux en-Y gastric bypass for gastroesophageal reflux disease after sleeve gastrectomy

Bariatric surgery is a proven, efficacious, and durable treatment for obesity and weight-related diseases. In addition to other metabolic effects, surgery can have both a positive and negative clinical impact on GERD. The spectrum of surgical procedures currently offered have varying degrees of improvement or worsening of pre-existing symptoms or development of new symptoms. Of the most commonly performed bariatric procedures, Roux en-Y gastric bypass has been shown to be highly effective in treatment of GERD1, likely through a combination of weight loss and subsequent decrease of intra-abdominal pressure, as well as separation of the majority of the parietal cell mass of the stomach by creating a small pouch excluding the fundus.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research

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AbstractPurpose of ReviewKnowledge regarding postoperative outcomes after bariatric and metabolic surgery continues to evolve. This review highlights key findings in outcomes research over the last 5  years related to weight loss, remission of obesity-related disease, reflux, revisional surgery, robotic-assisted surgical platforms, and adolescent populations.Recent FindingsSleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) produce similar weight loss patterns at 5  years, while duodenal switch (BPD/DS) and related procedures are associated with maximal weight loss overall and optimal resolution of obesit...
Source: Current Obesity Reports - Category: Eating Disorders & Weight Management Source Type: research
Bariatric surgery is a proven, efficacious, and durable treatment for obesity and weight-related diseases. In addition to other metabolic effects, surgery can have both a positive and negative clinical impact on gastroesophageal reflux disease (GERD). The spectrum of surgical procedures currently offered have varying degrees of improvement or worsening of preexisting symptoms or development of new symptoms. Of the most commonly performed bariatric procedures, Roux en-Y gastric bypass (RYGB) has been shown to be highly effective in treatment of GERD [1], likely through a combination of weight loss and subsequent decrease of...
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Editorial comment Source Type: research
Conclusion: GERD may improve in obese patients who underwent laparoscopic sleeve gastrectomy (LSG); however, the most favorable effect is likely to be found after Roux-en-Y gastric bypass surgery. Prospero registration number: CRD42018090074.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research
ConclusionsForegut pathology is common in bariatric patients with subjective symptoms of GERD. Implementing a comprehensive protocol to objectively assess these patients leads to a significant clinical impact on which procedure these patients ultimately undergo.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
This study included patients who underwent primary laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG). The primary outcome of interest was incisional SSI occurring within 30  days. Surgeries performed in 2015 were used in a derivation cohort and the predictive tool was validated against the 2016 cohort. A forward selection algorithm was used to build a logistic regression model predicting probability of SSI.ResultsA total of 274,187 patients were included with 71.7% being LSG and 28.3% LRYGB. 0.7% of patients had a SSI in which 71.0% had an incisional SSI, and 29.9% had an organ/spa...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
ConclusionA tailored HIDA scan protocol with addition of a SPECT-CT scan, ingestion of a fatty meal and prolonged scanning duration results in enhanced bile reflux detection in post-bariatric surgical patients.
Source: Obesity Surgery - Category: Surgery Source Type: research
ConclusionsComparative trials remain necessary between N-Sleeve and standard bariatric procedures to refine the specific indications of each of them and determine the eventual role of the N-Sleeve.
Source: Obesity Surgery - Category: Surgery Source Type: research
AbstractObjectiveTo evaluate the impact of laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) on gastroesophageal reflux disease (GERD) in patients with obesity.MethodsPatients with class II or III obesity were treated with LSG or LRYGB. Procedure choice was based on patients and surgeon preferences. GERD symptoms, endoscopy, barium swallow X-ray, esophageal manometry, and 24-h pH monitoring were obtained before and 1 year after surgery.ResultsSeventy-five patients underwent surgery (83% female, 39.3 ± 12.1 years, BMI of 41.5 ± 5.1 kg/m2): 35 (46.7%) had LSG and 40 (53.3%) ...
Source: Obesity Surgery - Category: Surgery Source Type: research
AbstractPurpose of reviewBariatric surgery and endoluminal bariatric therapies (EBTs) form an increasingly utilized therapeutic approach to treat obese patients but may worsen gastroesophageal reflux disease (GERD). In this updated article, we review the evidence on the effects of bariatric procedures on GERD.FindingsRecent evidence implicates sleeve gastrectomy with the highest rates of de novo GERD and Barrett ’s esophagus (BE), whereas malabsorptive-restrictive procedures such as Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB) were shown to have significantly lower reported rates. The int...
Source: Current Treatment Options in Gastroenterology - Category: Gastroenterology Source Type: research
ConclusionsBoth LRYGB and LSG have comparative effect on resolving T2DM in nonseverely obese patients at midterm follow-up. Further RCTs should address the potential risks and long-term effects of LRYGB and LSG in nonseverely obese patients.
Source: Obesity Surgery - Category: Surgery Source Type: research
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