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Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) is considered the weight loss procedure of choice for patients suffering of gastro-esophageal reflux (GER). However, long term instrumental evaluations of GER after LRYGB are not available.
The aim of this study is to evaluate the long-term effects of laparoscopic Roux-en-Y Gastric Bypass (LRYGB) on gastro-esophageal function.
Consecutive morbidly obese patients selected for LRYGB were included in a prospective study. The investigators performed clinical evaluation with GERD-HRQoL and GIS questionnaire, upper endoscopy, esophageal manometry and 24h-impedance pH monitoring (24h-MII-pH) preoperatively and at 12 and 60 months after surgery. Patients were divided into 2 groups according to the presence of GER at preoperative 24h-MII-pH.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Obese patients without preoperative GER | Obese patients selected for laparoscopic Roux-en-Y Gastric Bypass without preoperative GER at 24h-impedance pH monitoring (Group G-) | ||
| Obese patients with preoperative GER | Obese patients selected for laparoscopic Roux-en-Y Gastric Bypass with preoperative GER at 24h-impedance pH monitoring (Group G+) |
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| Measure | Description | Time Frame |
|---|---|---|
| Number of weakly acidic reflux | number of weakly acidic reflux at 24 hour pH impedance monitoring | preoperatively, 12 and 60 months after LRYGB |
| Measure | Description | Time Frame |
|---|---|---|
| GERD-HRQoL clinical score | Standard and previous validated questionnaire was employed in the study to assess gastroesophageal function and quality of life | preoperatively, 12 and 60 months after LRYGB |
| Lower esophageal sphincter pressure |
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Inclusion Criteria:
Exclusion Criteria:
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Consecutive morbidly obese patients selected for LRYGB
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 19190606 | Result | Vela MF. Non-acid reflux: detection by multichannel intraluminal impedance and pH, clinical significance and management. Am J Gastroenterol. 2009 Feb;104(2):277-80. doi: 10.1038/ajg.2008.23. No abstract available. | |
| 12184547 | Result | Sundbom M, Hedenstrom H, Gustavsson S. Duodenogastric bile reflux after gastric bypass: a cholescintigraphic study. Dig Dis Sci. 2002 Aug;47(8):1891-6. doi: 10.1023/a:1016429603337. |
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| ID | Term |
|---|---|
| D005764 | Gastroesophageal Reflux |
| D009765 | Obesity |
| ID | Term |
|---|---|
| D015154 | Esophageal Motility Disorders |
| D003680 | Deglutition Disorders |
| D004935 | Esophageal Diseases |
| D005767 | Gastrointestinal Diseases |
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Esophageal manometry measures lower esophageal sphincter pressure
| preoperatively, 12 and 60 months after LRYGB |
| Amplitude of esophageal peristaltic waves | Esophageal manometry evaluates amplitude of esophageal peristalsis | preoperatively, 12 and 60 months after LRYGB |
| Grade of esophagitis | Upper endoscopy is performed to assess the presence of esophagitis | preoperatively, 12 and 60 months after LRYGB |
| Number of acidic reflux | number of acidic reflux at 24 hour pH impedance monitoring | preoperatively, 12 and 60 months after LRYGB |
| 10875990 | Result | Collard JM, Romagnoli R. Roux-en-Y jejunal loop and bile reflux. Am J Surg. 2000 Apr;179(4):298-303. doi: 10.1016/s0002-9610(00)00326-3. |
| 15122609 | Result | Mabrut JY, Collard JM, Romagnoli R, Gutschow C, Salizzoni M. Oesophageal and gastric bile exposure after gastroduodenal surgery with Henley's interposition or a Roux-en-Y loop. Br J Surg. 2004 May;91(5):580-5. doi: 10.1002/bjs.4569. |
| 12119661 | Result | Barak N, Ehrenpreis ED, Harrison JR, Sitrin MD. Gastro-oesophageal reflux disease in obesity: pathophysiological and therapeutic considerations. Obes Rev. 2002 Feb;3(1):9-15. doi: 10.1046/j.1467-789x.2002.00049.x. |
| 27429035 | Derived | Rebecchi F, Allaix ME, Ugliono E, Giaccone C, Toppino M, Morino M. Increased Esophageal Exposure to Weakly Acidic Reflux 5 Years After Laparoscopic Roux-en-Y Gastric Bypass. Ann Surg. 2016 Nov;264(5):871-877. doi: 10.1097/SLA.0000000000001775. |
| D004066 | Digestive System Diseases |
| D050177 | Overweight |
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |