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Outcome of esophageal function and 24-hour esophageal pH monitoring after vertical banded gastroplasty and Roux-en-Y gastric bypass.

Abstract

BACKGROUND

One of the co-morbidities frequently associated with morbid obesity is gastro-esophageal reflux disease (GERD), present in >50 % of morbidly obese individuals. We compared the anti-reflux effect of vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGBP), and their effect on esophageal function.

METHODS

10 patients underwent VBG and 40 patients underwent RYGBP. Anthropometric parameters, symptomatology of GERD, esophageal manometry (EM), isotopic esophageal emptying (IEE) and 24 hr esophageal pH monitoring were recorded in all patients preoperatively, and at 3 months and 1 year postoperatively.

RESULTS

Preoperatively, there was a high prevalence of GERD, symptomatic and pH-metric in both groups (57% and 80% respectively). The preoperative values of EM and IEE parameters were within the normal range in most patients. After surgery, there was an improvement at 3 months postoperatively in both groups. 1 year after surgery, the VBG group presented symptomatic GERD in 30% and pH-metric reflux in 60% of patients while the RYGBP group presented symptomatic GERD and pH-metric reflux in 12.5% and 15% of patients, respectively. There was an increase in postoperative sensation of dysphagia in both groups (70% VBG, 30% RYGBP) one year after operation. After surgery, differences in all EM parameters were minimal, and never reached statistical significance for any group (VBG and RYGBP). The IEE showed a significantly higher percentage of esophageal retention after surgery, but this retention was always within the normal range. Both groups had an improvement in anthropometric parameters, but 1 year after surgery the results were significantly better in RYGBP patients (70% excess weight loss) than in VBG patients (46% excess weight loss).

CONCLUSION

>50% of morbidly obese individuals suffer from GERD. We did not find changes in esophageal function of morbidly obese patients to explain their gastroesophageal reflux preoperatively and postoperatively. EM and IEE studies are not indicated as standard preoperative tests, except in patients with significant symptoms of gastroesophageal reflux. RYGBP is significantly better than VBG as an anti-reflux procedure, and had better weight loss.

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  • Authors+Show Affiliations

    ,

    Department of Surgery, Unit of Endocrine and Metabolic Surgery, Hospital Clinico Universitario, Universitat de Valencia, Valencia, Spain. joaquin.ortega@uv.es

    , , , , , , , ,

    Source

    Obesity surgery 14:8 2004 Sep pg 1086-94

    MeSH

    Adult
    Anastomosis, Roux-en-Y
    Diagnostic Techniques, Digestive System
    Esophagus
    Female
    Gastric Bypass
    Gastroesophageal Reflux
    Gastroplasty
    Humans
    Hydrogen-Ion Concentration
    Male
    Obesity, Morbid
    Prospective Studies
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    15479598

    Citation

    Ortega, Joaquin, et al. "Outcome of Esophageal Function and 24-hour Esophageal pH Monitoring After Vertical Banded Gastroplasty and Roux-en-Y Gastric Bypass." Obesity Surgery, vol. 14, no. 8, 2004, pp. 1086-94.
    Ortega J, Escudero MD, Mora F, et al. Outcome of esophageal function and 24-hour esophageal pH monitoring after vertical banded gastroplasty and Roux-en-Y gastric bypass. Obes Surg. 2004;14(8):1086-94.
    Ortega, J., Escudero, M. D., Mora, F., Sala, C., Flor, B., Martinez-Valls, J., ... Lledo, S. (2004). Outcome of esophageal function and 24-hour esophageal pH monitoring after vertical banded gastroplasty and Roux-en-Y gastric bypass. Obesity Surgery, 14(8), pp. 1086-94.
    Ortega J, et al. Outcome of Esophageal Function and 24-hour Esophageal pH Monitoring After Vertical Banded Gastroplasty and Roux-en-Y Gastric Bypass. Obes Surg. 2004;14(8):1086-94. PubMed PMID: 15479598.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Outcome of esophageal function and 24-hour esophageal pH monitoring after vertical banded gastroplasty and Roux-en-Y gastric bypass. AU - Ortega,Joaquin, AU - Escudero,Maria Dolores, AU - Mora,Francisco, AU - Sala,Carlos, AU - Flor,Blas, AU - Martinez-Valls,Jose, AU - Sanchiz,Vicente, AU - Martinez-Alzamora,Nieves, AU - Benages,Adolfo, AU - Lledo,Salvador, PY - 2004/10/14/pubmed PY - 2005/1/12/medline PY - 2004/10/14/entrez SP - 1086 EP - 94 JF - Obesity surgery JO - Obes Surg VL - 14 IS - 8 N2 - BACKGROUND: One of the co-morbidities frequently associated with morbid obesity is gastro-esophageal reflux disease (GERD), present in >50 % of morbidly obese individuals. We compared the anti-reflux effect of vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGBP), and their effect on esophageal function. METHODS: 10 patients underwent VBG and 40 patients underwent RYGBP. Anthropometric parameters, symptomatology of GERD, esophageal manometry (EM), isotopic esophageal emptying (IEE) and 24 hr esophageal pH monitoring were recorded in all patients preoperatively, and at 3 months and 1 year postoperatively. RESULTS: Preoperatively, there was a high prevalence of GERD, symptomatic and pH-metric in both groups (57% and 80% respectively). The preoperative values of EM and IEE parameters were within the normal range in most patients. After surgery, there was an improvement at 3 months postoperatively in both groups. 1 year after surgery, the VBG group presented symptomatic GERD in 30% and pH-metric reflux in 60% of patients while the RYGBP group presented symptomatic GERD and pH-metric reflux in 12.5% and 15% of patients, respectively. There was an increase in postoperative sensation of dysphagia in both groups (70% VBG, 30% RYGBP) one year after operation. After surgery, differences in all EM parameters were minimal, and never reached statistical significance for any group (VBG and RYGBP). The IEE showed a significantly higher percentage of esophageal retention after surgery, but this retention was always within the normal range. Both groups had an improvement in anthropometric parameters, but 1 year after surgery the results were significantly better in RYGBP patients (70% excess weight loss) than in VBG patients (46% excess weight loss). CONCLUSION: >50% of morbidly obese individuals suffer from GERD. We did not find changes in esophageal function of morbidly obese patients to explain their gastroesophageal reflux preoperatively and postoperatively. EM and IEE studies are not indicated as standard preoperative tests, except in patients with significant symptoms of gastroesophageal reflux. RYGBP is significantly better than VBG as an anti-reflux procedure, and had better weight loss. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/15479598/Outcome_of_esophageal_function_and_24_hour_esophageal_pH_monitoring_after_vertical_banded_gastroplasty_and_Roux_en_Y_gastric_bypass_ L2 - https://dx.doi.org/10.1381/0960892041975497 DB - PRIME DP - Unbound Medicine ER -