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Obesity Surgery

, Volume 21, Issue 2, pp 167–172 | Cite as

Erosive Esophagitis after Bariatric Surgery: Banded Vertical Gastrectomy versus Banded Roux-en-Y Gastric Bypass

  • Gustavo Peixoto Soares MiguelEmail author
  • João Luiz Moreira Coutinho Azevedo
  • Paulo Henrique Oliveira de Souza
  • João de Siqueira Neto
  • Felipe Mustafa
  • Évelyn Saiter Zambrana
  • Perseu Seixas de Carvalho
Clinical Research

Abstract

Background

Obesity is associated with gastroesophageal reflux disease. Roux-en-Y gastric bypass is the most performed bariatric procedure in the world, whereas sleeve gastrectomy is an emerging procedure. Both can be combined with the use of a Silastic® ring. The aim of this study was to compare the evolution of erosive esophagitis (EE) in patients who underwent Silastic® ring gastric bypass (SRGB) and Silastic® ring sleeve gastrectomy (SRSG) after a 1-year postoperative period.

Methods

We carried out a non-randomized, prospective, controlled clinical study. Sixty-five patients were enrolled based on the following inclusion criteria: female gender, age 20–60 years old, BMI 40–45 and written informed consent. The exclusion criteria were secondary obesity, alcohol or drug use, severe psychiatric disorder, binge-eating of sweets, and previous stomach or bowel surgery. The patients were divided into two groups—33 (51%) underwent SRSG and 32 (49%) patients underwent SRGB. All patients underwent an esophago-gastro-duodenoscopy during the preoperative period and at 12–14 months after the surgery.

Results

Preoperatively, 15 patients (23.8%) were found to have EE, six (19.4%) in the SRSG group and nine patients (28.1%) in the SRGB group (p = 0.7795). Postoperatively, there was an increase in the number of patients with EE in the SRSG group to 14 (45.2%) and a decrease in the SRGB group to two (6.3%), giving a total of 16 patients with EE (25.4%; p = 0.0007).

Conclusions

After 1 year of follow-up, we observed a worsening evolution of EE in the SRSG group, but improvement in the SRGB group.

Keywords

Bariatric surgery Erosive esophagitis Roux-en-Y gastric bypass Sleeve gastrectomy Morbid obesity 

Notes

Acknowledgments

The authors would like to thank Drs. Marcos Machado Reuter Motta and José Manoel Binda, endoscopists from HUCAM-UFES, for performing the EGDs.

Conflict of Interest Disclosure

The authors declare that they have no conflict of interest.

References

  1. 1.
    Sjöström L, Narbro K, Sjöström D, et al. Swedish obese subjects study. Effects of bariatric surgery mortality Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRefPubMedGoogle Scholar
  2. 2.
    Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes Surg. 2004;14(9):1157–64.CrossRefPubMedGoogle Scholar
  3. 3.
    Lee CM, Cirangle PT, Jossart GH. Vertical gastrectomy for morbid obesity in 216 patients: report of two-year results. Surg Endosc. 2007;21:1810–6.CrossRefPubMedGoogle Scholar
  4. 4.
    Baltasar A, Serra C, Perez N, et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg. 2005;15(8):1124–8.CrossRefPubMedGoogle Scholar
  5. 5.
    Valezi AC, Brito EM, Souza JCL, et al. A importância do anel de silicone na derivação gástrica em Y de Roux para o tratamento da obesidade. Rev Col Bras Cir. 2008;35:18–22.Google Scholar
  6. 6.
    Miguel GPS, Azevedo JLMC, Gicovate-Neto C, et al. Glucose homeostasis and weight loss in morbidly obese patients undergoing banded sleeve gastrectomy: a prospective clinical study. Clinics. 2009;64:1093–8.CrossRefPubMedGoogle Scholar
  7. 7.
    Suter M, Dorta G, Giusti V, et al. Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients. Obes Surg. 2004;14:959–66.CrossRefPubMedGoogle Scholar
  8. 8.
    Mejía-Rivas MA, Herrera-López A, Hernández-Calleros J, et al. Gastroesophageal reflux disease in morbid obesity: the effect of Roux-en-Y gastric bypass. Obes Surg. 2008;18:1217–24.CrossRefPubMedGoogle Scholar
  9. 9.
    Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.CrossRefPubMedGoogle Scholar
  10. 10.
    Sillecchia G, Boru C, Pecchia A, et al. Effectiveness of laparoscopic sleeve gastrectomy (first stage of biliopancreatic diversion with duodenal switch) on co-morbidities in super-obese high-risk patients. Obes Surg. 2006;16:1138–44.CrossRefGoogle Scholar
  11. 11.
    Moon Han S, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.CrossRefPubMedGoogle Scholar
  12. 12.
    Vidal J, Ibarzabal A, Romero F, et al. Type 2 diabetes mellitus and the metabolic syndrome following sleeve gastrectomy in severely obese subjects. Obes Surg. 2008;18:1077–82.CrossRefPubMedGoogle Scholar
  13. 13.
    Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15(7):1024–29.CrossRefPubMedGoogle Scholar
  14. 14.
    Cai J, Zheng C, Xu L, et al. Therapeutic effects of sleeve gastrectomy plus gastric remnant banding on weight reduction and gastric dilation: an animal study. Obes Surg. 2008;18:1411–7.CrossRefPubMedGoogle Scholar
  15. 15.
    Greenstein AJ, Vine AJ, Jacob BP. When sleeve gastrectomy fails: adding a laparoscopic adjustable gastric band to increase restriction. Surg Endosc. 2009;23(4):884.CrossRefPubMedGoogle Scholar
  16. 16.
    Braghetto I, Korn O, Valladares H, et al. Laparoscopic sleeve gastrectomy: surgical technique, indications and clinical results. Obes Surg. 2007;17:1442–50.CrossRefPubMedGoogle Scholar
  17. 17.
    Alexander JW, Hawver LRM, Goodman HR. Banded sleeve gastrectomy—initial experience. Obes Surg. 2009;19:1591–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the Indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.CrossRefPubMedGoogle Scholar
  19. 19.
    Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450–6.CrossRefPubMedGoogle Scholar
  20. 20.
    Bohdjalian A, Langer FB, Shakeri-Leidenmühler S. Sleeve gastrectomy as sole and definitive bariatric procedure: 5-year results for weight loss and ghrelin. Obes Surg. 2010;20:535–40.CrossRefPubMedGoogle Scholar
  21. 21.
    Frezza EE, Ikramuddin S, Gourash W, et al. Symptomatic improvement in gastroesophageal reflux disease (GERD) following laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2002;16:1027–31.CrossRefPubMedGoogle Scholar
  22. 22.
    Tai CM, Lee YC, Wu MS, et al. The effect of Roux-en-Y gastric bypass on gastroesophageal reflux disease in morbidly obese Chinese patients. Obes Surg. 2009;19:565–70.CrossRefPubMedGoogle Scholar
  23. 23.
    Csendes JA, Burgos LAM, Smok SG, et al. Efecto del bypass gastric en la esofagitis erosiva en pacientes con obesidad mórbida. Rev Med Chile. 2006;134:285–90.Google Scholar
  24. 24.
    Merrouche M, Sabaté JM, Jouet P, et al. Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients before and after bariatric surgery. Obes Surg. 2007;17:894–900.CrossRefPubMedGoogle Scholar
  25. 25.
    Gagner M, Deitel M. Second international consensus for sleeve gastrectomy (ICSSG) questionnaire. Obes Surg. 2009;19:964.CrossRefGoogle Scholar
  26. 26.
    Angrisani L, Basso N, Foletto M, et al. Sleeve gastrectomy in Italy: a nationwide survey on 698 patients. Obes Surg. 2009;19:963.Google Scholar
  27. 27.
    Bernstine H, Tzioni-Yehoshua R, Groshar D. Gastric emptying is not affected by sleeve gastrectomy—scintigraphic evaluation of gastric emptying after sleeve gastrectomy without removal of the gastric antrum. Obes Surg. 2009;19:293–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Melissas J, Daskalakis M, Koukouraki S, et al. Sleeve gastrectomy—a food “limiting” operation. Obes Surg. 2008;18:1251–6.CrossRefPubMedGoogle Scholar
  29. 29.
    Melissas J, Koukouraki S, Askoxylakis J, et al. Sleeve gastrectomy—a restrictive procedure? Obes Surg. 2007;17:57–62.CrossRefPubMedGoogle Scholar
  30. 30.
    Braghetto I, Davanzo C, Korn O, et al. Scintigraphic evaluation of gastric emptying in obese patients submitted to sleeve gastrectomy compared to normal subjects. Obes Surg. 2009;19:1515–21.CrossRefPubMedGoogle Scholar
  31. 31.
    DeVault KR, Castell DO. Updated guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Am J Gastroenterol 2005; 190–200.Google Scholar
  32. 32.
    Korenkov M, Sauerland S, Shah S, et al. Is routine preoperative upper endoscopy in gastric banding patients really necessary? Obes Surg. 2006;16:45–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2010

Authors and Affiliations

  • Gustavo Peixoto Soares Miguel
    • 1
    Email author
  • João Luiz Moreira Coutinho Azevedo
    • 2
  • Paulo Henrique Oliveira de Souza
    • 1
  • João de Siqueira Neto
    • 1
  • Felipe Mustafa
    • 1
  • Évelyn Saiter Zambrana
    • 1
  • Perseu Seixas de Carvalho
    • 1
  1. 1.Federal University of Espírito Santo–UFESVitóriaBrazil
  2. 2.Federal University of São Paulo–UnifespSão PauloBrazil

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