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：

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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，担心会进展为巴雷特食管 (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，占随访的 44.9%。无论症状如何，所有 SG 患者均接受内镜检查。结果包括总重量减轻百分比 (%TWL)、PPI 使用、食管炎进展、从头反流和 BE 形成。

结果

在术后随访中，%TWL 为 23%。平均 BMI 从 49.07 下降到 37.5。13 点 (30.9%) 出现新发反流。在 16 例 GERD 术前患者中，37.5% 改善，25% 病情稳定，37.5% 症状恶化。食管炎的发病率几乎翻了一番，从术前的 37.9% 增加到术后的 70.6%。大多数术后患者有轻度食管炎（87.8%），其中 12.1% 有 LA C 和 D 级。68.2% 的术后患者出现无症状食管炎。术后 BE 的发生率为 12.7%，新发 BE 发生率为 4 例，占 7.2%。

结论

SG 与术后 3 至 4 年无症状食管炎和新发反流的发生率增加有关。De novo BE 也被检测到，突出了术后筛查的重要性。大多数 GERD 术前患者病情稳定或好转。

图形概要