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Symptomatic and clinical improvement in morbidly obese patients with gastroesophageal reflux disease following Roux-en-Y gastric bypass.
Obes Surg. 1997 Dec; 7(6):479-84.OS

Abstract

BACKGROUND

Patients who suffer with gastroesophageal reflux Disease (GERD) endure a worsening of symptoms as their weight increases. When medical treatment of this condition in the morbidly obese patients fails, surgical intervention may be indicated. Choosing a procedure which not only helps achieve weight control but which also relieves symptoms and complications of GERD is the goal. We present a review of patients who have undergone Roux-en-Y Gastric Bypass (RYGBP) and related procedures for this disease.

METHODS

One hundred eighty-eight patients undergoing surgery for morbid obesity and for GERD in 1992-1996 were contacted by mail or phone. All of these patients had undergone preoperative esophagogastroduodenoscopy to grade the severity of their disease. Their preoperative symptoms were compared to those experienced postoperatively.

RESULTS

One hundred thirty patients underwent a RYGBP with modified Hill fundopexy, 22 patients underwent a distal gastrectomy with modified Hill fundopexy, 8 patients underwent distal gastrectomy alone and 28 patients underwent RYGBP alone. There have been no deaths. There were nine surgical complications, eight early and one at 2.5 years postoperation. Follow-up is 4-48 months. The average BMI dropped from 43 to 30.2 kg/m2. Whereas all patients were on some form of medical therapy before surgery, only 14 reported the need for medication postoperatively.

CONCLUSIONS

Surgical intervention for weight control and treatment of GERD has been highly successful in our experience both with respect to weight control and to the reduction of reflux symptoms. Depending upon endoscopic and operative findings a RYGBP with or without an antireflux procedure can provide dramatic improvement. Gastrectomy with antireflux modifications is appropriate in selected cases.

Authors+Show Affiliations

Rocky Mountain Associated Physicians, Salt Lake City, Utah, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

9730504

Citation

Smith, S C., et al. "Symptomatic and Clinical Improvement in Morbidly Obese Patients With Gastroesophageal Reflux Disease Following Roux-en-Y Gastric Bypass." Obesity Surgery, vol. 7, no. 6, 1997, pp. 479-84.
Smith SC, Edwards CB, Goodman GN. Symptomatic and clinical improvement in morbidly obese patients with gastroesophageal reflux disease following Roux-en-Y gastric bypass. Obes Surg. 1997;7(6):479-84.
Smith, S. C., Edwards, C. B., & Goodman, G. N. (1997). Symptomatic and clinical improvement in morbidly obese patients with gastroesophageal reflux disease following Roux-en-Y gastric bypass. Obesity Surgery, 7(6), 479-84.
Smith SC, Edwards CB, Goodman GN. Symptomatic and Clinical Improvement in Morbidly Obese Patients With Gastroesophageal Reflux Disease Following Roux-en-Y Gastric Bypass. Obes Surg. 1997;7(6):479-84. PubMed PMID: 9730504.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Symptomatic and clinical improvement in morbidly obese patients with gastroesophageal reflux disease following Roux-en-Y gastric bypass. AU - Smith,S C, AU - Edwards,C B, AU - Goodman,G N, PY - 1998/9/8/pubmed PY - 1998/9/8/medline PY - 1998/9/8/entrez SP - 479 EP - 84 JF - Obesity surgery JO - Obes Surg VL - 7 IS - 6 N2 - BACKGROUND: Patients who suffer with gastroesophageal reflux Disease (GERD) endure a worsening of symptoms as their weight increases. When medical treatment of this condition in the morbidly obese patients fails, surgical intervention may be indicated. Choosing a procedure which not only helps achieve weight control but which also relieves symptoms and complications of GERD is the goal. We present a review of patients who have undergone Roux-en-Y Gastric Bypass (RYGBP) and related procedures for this disease. METHODS: One hundred eighty-eight patients undergoing surgery for morbid obesity and for GERD in 1992-1996 were contacted by mail or phone. All of these patients had undergone preoperative esophagogastroduodenoscopy to grade the severity of their disease. Their preoperative symptoms were compared to those experienced postoperatively. RESULTS: One hundred thirty patients underwent a RYGBP with modified Hill fundopexy, 22 patients underwent a distal gastrectomy with modified Hill fundopexy, 8 patients underwent distal gastrectomy alone and 28 patients underwent RYGBP alone. There have been no deaths. There were nine surgical complications, eight early and one at 2.5 years postoperation. Follow-up is 4-48 months. The average BMI dropped from 43 to 30.2 kg/m2. Whereas all patients were on some form of medical therapy before surgery, only 14 reported the need for medication postoperatively. CONCLUSIONS: Surgical intervention for weight control and treatment of GERD has been highly successful in our experience both with respect to weight control and to the reduction of reflux symptoms. Depending upon endoscopic and operative findings a RYGBP with or without an antireflux procedure can provide dramatic improvement. Gastrectomy with antireflux modifications is appropriate in selected cases. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/9730504/Symptomatic_and_clinical_improvement_in_morbidly_obese_patients_with_gastroesophageal_reflux_disease_following_Roux_en_Y_gastric_bypass_ L2 - https://dx.doi.org/10.1381/096089297765555205 DB - PRIME DP - Unbound Medicine ER -