Comparação dos níveis plasmáticos de grelina nos períodos pré e pós-operatório em pacientes submetidos à plicatura gástrica associada à fundoplicatura

Ivano, Flávio Heuta; Silva, Léia de Mello; Seniski, Gerusa Gabriele; Menacho, Aline Moraes; Chigueira, Micheli Angelo; Barros, Renar

doi:10.1590/s0102-67202013000600003

Cited by 6 publications

(4 citation statements)

References 12 publications

(7 reference statements)

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“…GP is a restrictive surgical method, which consists of reducing the intragastric space by imbricating the greater curvature wall with suture 7 , 8 . Previous studies by the same surgical team, showed that it is a feasible technique and has a mechanism of restriction like that of sleeve gastrectomy, albeit without any stapling or organ resection 8 .…”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatment is a viable option for individuals refractory to continuous or intermittent drug treatment. It classically consists of total fundoplication associated with hiatal hernia repair, leading to more than an estimated 90% improvement in symptoms 4 , 7 . Nevertheless, the effectiveness of the treatment is compromised in individuals with overweight or obesity 14 .…”

Section: Introductionmentioning

confidence: 99%

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GASTRIC PLICATION ASSOCIATED WITH FUNDOPLICATION IN INDIVIDUALS WITH CLASS I OBESITY AND GASTROESOPHAGEAL REFLUX DISEASE: WEIGHT LOSS OUTCOMES, REFLUX-RELATED SYMPTOMS, ENDOSCOPIC AND pH MONITORING FINDINGS

Ivano,

Apodaca-Rueda,

Morisawa

et al. 2023

ABCD, arq. bras. cir. dig.

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BACKGROUND: The association of gastric plication with fundoplication is a reliable option for the treatment of individuals with obesity associated with gastroesophageal reflux disease. AIMS: To describe weight loss, endoscopic, and gastroesophageal reflux disease-related outcomes of gastric plication with fundoplication in individuals with mild obesity. METHODS: A retrospective cohort study was carried out, enrolling individuals who underwent gastric plication with fundoplication at a tertiary private hospital from 2015–2019. Data regarding perioperative and weight loss outcomes, endoscopic and 24-hour pH monitoring findings, and gastroesophageal reflux disease-related symptoms were analyzed. RESULTS: Of 98 individuals, 90.2% were female. The median age was 40.4 years (IQR 32.1–47.8). The median body mass index decreased from 32 kg/m2 (IQR 30,5–34) to 29.5 kg/m2 (IQR 26.7–33.9) at 1–2 years (p<0.05); and to 27.4 kg/m2 (IQR 24.1–30.6) at 2–4 years (p=0.059). The median percentage of total weight loss at 1–2 years was 7.8% (IQR −4.1–14.7) and at 2–4 years, it was 16.4% (IQR 4.3–24.1). Both esophageal and extra-esophageal symptoms showed a significant reduction (p<0.05). A significant decrease in the occurrence of esophagitis was observed (p<0.01). The median DeMeester score decreased from 30 (IQR 15.1–48.4) to 1.9 (IQR 0.93–5.4) (p<0.0001). CONCLUSIONS: The gastric plication with fundoplication proved to be an effective and safe technique, leading to a significant and sustained weight loss in addition to endoscopic and clinical improvement of gastroesophageal reflux disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

GASTRIC PLICATION ASSOCIATED WITH FUNDOPLICATION IN INDIVIDUALS WITH CLASS I OBESITY AND GASTROESOPHAGEAL REFLUX DISEASE: WEIGHT LOSS OUTCOMES, REFLUX-RELATED SYMPTOMS, ENDOSCOPIC AND pH MONITORING FINDINGS

Ivano,

Apodaca-Rueda,

Morisawa

et al. 2023

ABCD, arq. bras. cir. dig.

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“…The gastroesophageal reflux disease (GERD), which is often related to overweight and obesity comorbidity, is a chronic condition characterized by a retrograde flow of gastric contents (hydrochloric acid) and/or duodenal (bile salts and pancreatic enzymes) in the absence vomiting 5 , 15 . The most common typical symptoms include heartburn and regurgitation associated with postprandial worsening and decubitus positions.…”

Section: Introductionmentioning

confidence: 99%

“…The most common typical symptoms include heartburn and regurgitation associated with postprandial worsening and decubitus positions. Other secondary atypical symptoms include epigastric pain, postprandial fullness, chest pain, nausea and dysphagia 7 , 15 . The pathophysiological mechanisms that support the emergence of this disease include hypotonia of the lower esophageal sphincter, hiatal hernia, increased abdominal pressure due to excess weight, previous abdominal plastic surgeries and inefficient motility of the esophagus 6 .…”

Section: Introductionmentioning

confidence: 99%

Pre and Postoperative Ph Monitoring and Weight Loss Analysis in Patients Undergoing Gastric Plication in Association With Fundoplication

Ivano¹,

Mesquita²,

Simamura³

et al. 2017

ABCD, arq. bras. cir. dig.

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-Background:Obese patients with gastroesophageal reflux disease with pathological pH monitoring result may benefit from surgical treatment which is based on the fundoplication technique in association with laparoscopic gastric plication. The Nissen surgery is the gold standard for surgical treatment of gastroesophageal reflux disease, whereas laparoscopic gastric plication is a restrictive surgery that consists of the invagination of the greater curvature, resulting in weight loss. Aim: To compare pre and postoperative pHmetry results and to evaluate weight loss in patients submitted to gastroplasty with fundoplication. Method: Sixteen patients with class I body mass index with symptoms of gastroesophageal reflux with changes of stomach pH and/or erosive esophagitis seen in endoscopy were selected The evaluation of the weight and 24-h pH monitoring was performed preoperatively and postoperatively. The weight, body mass index, percentage of excess weight loss and DeMeester score of patients that underwent the surgery were evaluated pre and postoperatively. Results: Regarding pH monitoring, the average preoperative DeMeester index was 28.7, which was followed by a significant postoperative average reduction to 2.8 (p<0,001). Regarding the weight reduction, the average of weight loss was 13.6 kg and body mass index of 5.3 kg/m 2 (p<0.001). Furthermore, the average percentage of excess weight loss was 53.9% (standard deviation=26.2). Conclusion: The combination of Nissen surgery and gastric plication is a viable procedure and appears to be an acceptable option for the treatment of gastroesophageal reflux disease in obese patients, especially patients with obesity class I. RESUMO -Racional:Pacientes que apresentam obesidade e doença do refluxo gastroesofágico comprovada com pHmetria, podem se beneficiar do tratamento cirúrgico que se baseia na união da técnica da fundoplicatura e gastroplicatura laparoscópicas. A operação de Nissen é o padrão-ouro para o tratamento cirúrgico; já a gastroplicatura laparoscópica é operação restritiva, cuja técnica é a invaginação intraluminar da parede da grande curvatura, o que resulta na perda de peso. Objetivo: Comparar os resultados da pHmetria pré e pós-operatórias e avaliar a perda de peso em pacientes submetidos à gastroplicatura com fundoplicatura. Método: Foram selecionados 16 pacientes com IMC em obesidade grau I, associado aos sintomas de doença do refluxo gastroesofágico, e com pHmetria alterada e/ou esofagite erosiva na endocopia digestiva alta. A avaliação do peso e da pHmetria de 24 h foi realizada no pré e pós-operatório. As variáveis foram: peso pré e pós-operatório, IMC, percentual da perda do excesso de peso e escore de DeMeester. Resultados: Dos 16 pacientes em relação à pHmetria a média pré-operatória do índice de DeMeester foi de 28,7, verificando-se na sequência redução significativa para média pós-operatória de 2,8 (p<0,001). Em relação ao peso, a média da redução foi de 13,6 kg e do índice de massa corporal de 5,3 kg/m 2 (p<0,001). A média do percentua...

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Body mass index and ghrelin levels after laparoscopic Nissen fundoplication

Yiğit

Coşkun

Harlak

et al. 2015

Langenbecks Arch Surg

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Comparação dos níveis plasmáticos de grelina nos períodos pré e pós-operatório em pacientes submetidos à plicatura gástrica associada à fundoplicatura

Abstract: Gastric plication associated with fundoplication was effective in treating reflux disease with surgical indication and for weight loss in obese patients. Appetite control occurs, but not due to ghrelin, because no significant decrease of its plasmatic levels was observed.

Cited by 6 publications

References 12 publications

GASTRIC PLICATION ASSOCIATED WITH FUNDOPLICATION IN INDIVIDUALS WITH CLASS I OBESITY AND GASTROESOPHAGEAL REFLUX DISEASE: WEIGHT LOSS OUTCOMES, REFLUX-RELATED SYMPTOMS, ENDOSCOPIC AND pH MONITORING FINDINGS

GASTRIC PLICATION ASSOCIATED WITH FUNDOPLICATION IN INDIVIDUALS WITH CLASS I OBESITY AND GASTROESOPHAGEAL REFLUX DISEASE: WEIGHT LOSS OUTCOMES, REFLUX-RELATED SYMPTOMS, ENDOSCOPIC AND pH MONITORING FINDINGS

Pre and Postoperative Ph Monitoring and Weight Loss Analysis in Patients Undergoing Gastric Plication in Association With Fundoplication

Body mass index and ghrelin levels after laparoscopic Nissen fundoplication

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