Gastroesophageal Reflux Disease, Esophagitis, and Barrett’s Esophagus 3 to 4 Years Post Sleeve Gastrectomy,Obesity Surgery

当前位置： X-MOL 学术 › Obes. Surg. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Gastroesophageal Reflux Disease, Esophagitis, and Barrett’s Esophagus 3 to 4 Years Post Sleeve Gastrectomy
Obesity Surgery ( IF 2.9 ) Pub Date : 2021-10-02 , DOI: 10.1007/s11695-021-05688-0
Samer Elkassem _{1,

2}

Affiliation

Background

Sleeve gastrectomy (SG) has become the most popular bariatric procedure worldwide. However, SG is associated with de novo gastroesophageal reflux (GERD) and esophagitis, with concerns for progression into Barrett’s esophagus (BE). The purpose of this study is to assess the clinical and endoscopic progression of GERD, esophagitis, and BE 3 to 4 years after SG.

Methods

Fifty-eight patients (pts) were assessed with endoscopy preoperative and at 3 to 4 years post SG, representing 44.9% follow-up. Endoscopy was offered to all SG pts regardless of symptoms. Outcomes including percent total weight loss (%TWL), PPI use, esophagitis progression, de novo reflux, and BE formation.

Results

At post-op follow-up, the %TWL was 23%. The average BMI dropped from 49.07 to 37.5. De novo reflux developed in 13 pts (30.9%). Of the 16 pts with GERD pre-op, 37.5% improved, 25% had stable disease, and 37.5% had worsening symptoms. The rate of esophagitis nearly doubled from 37.9% pre-op to 70.6% post-op. A majority of post-op pts had mild esophagitis (87.8%), with 12.1% with LA classes C and D. Asymptomatic esophagitis was found in 68.2% of post-op pts. The incidence of BE was 12.7% post-op, with de novo BE developing in 4 pts, representing 7.2%.

Conclusion

SG is associated with increased rates of asymptomatic esophagitis and de novo reflux at 3 to 4 years post-op. De novo BE was detected as well, highlighting the importance of post-op screening. The majority of pts with GERD pre-op have stable disease or improve.

Graphical abstract

中文翻译：

袖状胃切除术后 3 至 4 年的胃食管反流病、食管炎和巴雷特食管

背景

袖状胃切除术（SG）已成为全球最流行的减肥手术。然而，SG 与新发胃食管反流 (GERD) 和食管炎有关，并可能进展为巴雷特食管 (BE)。本研究的目的是评估 SG 后 3 至 4 年 GERD、食管炎和 BE 的临床和内镜进展。

方法

58 名患者 (pts) 在术前和 SG 后 3 至 4 年接受了内窥镜检查，占随访率的 44.9%。无论症状如何，所有 SG 患者均接受内窥镜检查。结果包括总体重减轻百分比 (%TWL)、PPI 使用、食管炎进展、从头反流和 BE 形成。

结果

术后随访时，%TWL 为 23%。平均BMI从49.07下降至37.5。 13 名患者 (30.9%) 出现从头反流。在 16 名术前患有 GERD 的患者中，37.5% 的患者病情得到改善，25% 的患者病情稳定，37.5% 的患者症状恶化。食管炎的发生率从术前的 37.9% 增加到术后的 70.6%，几乎翻了一番。大多数术后患者有轻度食管炎（87.8%），其中 12.1% 为 LA C 级和 D 级。68.2% 的术后患者发现无症状食管炎。术后 BE 发生率为 12.7%，其中 4 例患者出现新发 BE，占 7.2%。