Effect of morbid obesity, gastric banding and gastric bypass on esophageal symptoms, mucosa and function

Borovicka, Jan; Krieger-Grübel, Claudia; Weg, Boudewijn van der; Thurnheer, Martin; Schultes, Bernd; Sulz, Michael Christian; Gutzwiler, Jean-Pierre; Bisang, Philipp; Pohl, Daniel; Fried, Michael; Meyenberger, Christa; Tutuian, Radu

doi:10.1007/s00464-016-4996-5

Cited by 15 publications

(9 citation statements)

References 11 publications

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“…A total of 32.3% of patients in the current study underwent R-RYGB as a treatment for GERD, supporting the findings of other studies in which 11 of 81 patients received R-RYGB for GERD [17]. GERD is a common long-term sequela of LAGB and LSG [26,27], and RYGB is an effective procedure when other modalities fail [27]. Notably, 26.4% of our patients underwent R-RYGB for one indication and 73.5% for > 1 indication.…”

Section: Discussionsupporting

confidence: 88%

Is Revisional Gastric Bypass as Effective as Primary Gastric Bypass for Weight Loss and Improvement of Comorbidities?

et al. 2019

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Background Revisional gastric bypass (R-RYGB) surgery is utilized for the management of inadequate weight loss or weight regain observed after some cases of bariatric surgeries. Data on the mid-term effectiveness of primary gastric bypass (P-RYGB) compared with R-RYGB (e.g., post sleeve gastrectomy/gastric banding) are controversial. Methods Retrospective chart review of all patients who received P-RYGB and R-RYGB (January 2011-June 2015) at our center. One hundred twenty patients who underwent P-RYGB and 34 R-RYGB who completed 18 months follow-up were included. We compared the effectiveness of P-RYGB with R-RYGB by assessing four anthropometric, two glycemic, and four lipid parameters, as well as the control of type 2 diabetes (T2DM), hypertension, dyslipidemia (remission, improvement, persistence, relapse, de novo), mortality and complications rates. Results A comparison of the effectiveness of P-RYGB with R-RYGB at 18 months revealed no significant differences in patients' age, gender, and preoperative BMI between groups. However, patients who received P-RYGB had lower mean weight (P = 0.001) and BMI (P < 0.001), reflected by a higher mean delta BMI (P = 0.02), total weight loss percentage (TWL%) (P < 0.0001) and excess weight loss percentage (EWL%) (P < 0.0001). No differences in glycemic parameters, lipid profiles, control of T2DM, hypertension, and dyslipidemia were observed. No death is reported and complication rates were comparable. Conclusions Although R-RYGB effectively addressed inadequate weight loss, weight regain, and recurrence of comorbidities after restrictive bariatric surgery, R-RYGB resulted in inferior weight loss compared with P-RYGB. Neither procedure differed in their clinical control of T2DM, hypertension, and dyslipidemia. Both procedures exhibited comparable complication rates.

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Section: Discussionsupporting

confidence: 88%

Is Revisional Gastric Bypass as Effective as Primary Gastric Bypass for Weight Loss and Improvement of Comorbidities?

et al. 2019

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“…A total of 194 articles were excluded at this stage because they clearly did not fulfill the eligibility criteria, leaving 51 articles for full-text review. Finally, 27 studies (15 studies for SG ( 23 – 37 ), 10 studies for RYGB ( 38 – 47 ), and 2 studies for both surgeries ( 13 , 48 )) were eligible for inclusion in the systematic review and meta-analysis. The flow diagram of the study selection process is shown in Supplementary Item 2, Supplemental Digital Content 4, http://links.lww.com/CTG/A344 .…”

Section: Resultsmentioning

confidence: 99%

Esophageal Pathophysiologic Changes and Adenocarcinoma After Bariatric Surgery: A Systematic Review and Meta-Analysis

Jaruvongvanich

Matar

Ravi

et al. 2020

Clin Transl Gastroenterol

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INTRODUCTION: To assess the effects of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) on acid reflux and esophageal motor function and to evaluate the observation of esophageal adenocarcinoma (EAC) after bariatric surgery. METHODS: We searched 5 databases for adults who underwent SG or RYGB and had esophageal pH test and/or esophageal manometry before and after surgery. A separate systemic search of observational studies and a retrospective review at 3 institutions of adults who developed EAC after these surgeries were conducted. Outcomes were changes in manometric and pH parameters and EAC cases after SG and RYGB. RESULTS: A total of 27 nonrandomized studies (SG: 612 patients; RYGB: 470 patients) were included. After SG, lower esophageal sphincter pressure and esophageal body amplitude were decreased and the risk of ineffective esophageal motility was increased. Total and recumbent acid exposure times were increased. After RYGB, an increased risk of ineffective esophageal motility was observed. Total, upright, and recumbent acid exposure times were decreased. The total reflux episodes remained unchanged but with increased nonacid reflux and decreased acid reflux events. Including our largest series, 31 EAC cases have been reported to date after SG and RYGB. DISCUSSION: This systematic review demonstrates increased acid reflux after SG and decreased acid reflux after RYGB. An observed increased nonacid reflux after RYGB might contribute to failure of gastroesophageal reflux disease improvement. This refluxate might be noxious to the esophagus, warranting further studies. RYGB might not entirely preserve esophageal function as previously believed.

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“…Recently childhood obesity between 9-13 years was highlighted as a risk factor for the future development of adenocarcinoma of esophagus [123] and squamous esophageal carcinoma in women [124]. This could be attributed to the increased prevalence of gastroesophageal reflux in obesity [125].…”

Section: Obesity-cancer In Adultsmentioning

confidence: 99%

Childhood Obesity and Its Associations with Morbidity and Mortality in Adult Life

Kakleas¹,

Soldatou²,

Kyriaki³

2018

Diabetes Complications

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Childhood and adulthood obesity has reached epidemic levels. Unfortunately, obesity tracks from childhood into adulthood and its persistence rises with age among obese children. Childhood obesity is associated with comorbidities, which are present even in childhood, including hypertension, endothelial dysfunction, insulin resistance and type 2 diabetes (T2D), fatty liver disease, obstructive sleep apnea and endocrine, musculoskeletal and psychosocial problems. Early onset obesity is a risk factor for morbidity and mortality later in life. The main causes of death of obese children and adolescents in adulthood include cardiovascular diseases, T2D and its complications, obstructive sleep apnea and cancer. Morbidity and mortality increase proportionately to the severity and duration of childhood obesity. Furthermore, body mass index (BMI) is associated with projected life expectancy. Decreased life expectancy is observed among obese, but also among lean individuals, with the best life expectancy being observed among normal weight and overweight people. Life expectancy has halted at present and further decrease due to the obesity epidemic is expected, if proper measures are not taken. The association between childhood obesity and adult morbidity and mortality strongly suggests that more effective prevention and treatment of childhood obesity should be pursued.

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Effect of morbid obesity, gastric banding and gastric bypass on esophageal symptoms, mucosa and function

Abstract: From an esophageal perspective, gastric bypass surgery induces less motility disorders and esophageal symptoms and should be therefore favored over gastric banding in difficult to treat obese patients at risk of repeated bariatric surgery.

Cited by 15 publications

References 11 publications

Is Revisional Gastric Bypass as Effective as Primary Gastric Bypass for Weight Loss and Improvement of Comorbidities?

Is Revisional Gastric Bypass as Effective as Primary Gastric Bypass for Weight Loss and Improvement of Comorbidities?

Esophageal Pathophysiologic Changes and Adenocarcinoma After Bariatric Surgery: A Systematic Review and Meta-Analysis

Childhood Obesity and Its Associations with Morbidity and Mortality in Adult Life

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