The Effect of Laparoscopic Sleeve Gastrectomy on Gastroesophageal Reflux Disease

Silveira, Flavia Carvalho; Poa-Li, Christina; Pergamo, Matthew; Gujral, Akash; Kolli, Sindhura; Fielding, George; Ren-Fielding, Christine; Schwack, Bradley

doi:10.1007/s11695-020-05111-0

Cited by 17 publications

(4 citation statements)

References 15 publications

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“…Mechanistically, VSG is expected to have a propensity for increased post-operative persistent and de novo GERD, and subsequently, need for GERD medications, incidence of reflux esophagitis, and Barrett metaplastic and dysplastic changes 12 . This has further been suggested in more recent smaller studies, which conclude that GERD symptoms are either improved or not exacerbated by VSG, although de novo incidence of GERD is greater 13,14 . The VSG is associated with a decreased lower esophageal sphincter pressure and increased total and recumbent acid exposure times, in comparison to RYGB 12 .…”

Section: Discussionmentioning

confidence: 94%

“…12 This has further been suggested in more recent smaller studies, which conclude that GERD symptoms are either improved or not exacerbated by VSG, although de novo incidence of GERD is greater. 13,14 The VSG is associated with a decreased lower esophageal sphincter pressure and increased total and recumbent acid exposure times, in comparison to RYGB. 12 Furthermore, a wrap operation is not feasible after a VSG, as these patients are sometimes converted to RYGB for refractory reflux or even BE.…”

Section: Discussionmentioning

confidence: 99%

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Gastroesophageal Reflux Disease Outcomes After Vertical Sleeve Gastrectomy and Gastric Bypass

et al. 2021

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Objective: The objective of this study is to assess whether vertical sleeve gastrectomy (VSG) increases the incidence of gastroesophageal reflux disease (GERD), esophagitis and Barrett esophagus (BE) relative to patients undergoing Roux-en-Y gastric bypass (RYGB) in patients with and without preoperative GERD. Summary of Background Data: Concerns for potentiation of GERD, supported by multiple high-quality retrospective studies, have hindered greater adoption of the VSG. Methods: From the OptumLabs Data Warehouse, VSG and RYGB patients with ≥2 years enrollment were identified and matched by follow-up time. GERD [reflux esophagitis, prescription for acid reducing medication (Rx) and/or diagnosis of BE], upper endoscopy (UE), and re-admissions were evaluated beyond 90 days. Results: A total of 8362 patients undergoing VSG were matched 1:1 to patients undergoing RYGB, on the basis of post-operative follow-up interval. Age, sex, and follow-up time were similar between the 2 groups (P > 0.05). Among all patients, postoperative GERD was more frequently observed in VSG patients relative to RYGB patients (60.2% vs 55.6%, respectively; P < 0.001), whereas BE was more prevalent in RYGB patients (0.7% vs 1.1%; P = 0.007). Postoperatively, de novo esophageal reflux symptomatology was more common in VSG patients (39.3% vs 35.3%; P < 0.001), although there was no difference in development of the histologic diagnoses reflux esophagitis and BE. Furthermore, postoperative re-admission was higher in the RYGB cohort (38.9% vs 28.9%; P < 0.001). Conclusions: Compared to RYGB, VSG may not have inferior long-term GERD outcomes, while also leading to fewer re-hospitalizations. These data challenge the prevailing opinion that patients with GERD should undergo RYGB instead of VSG.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Gastroesophageal Reflux Disease Outcomes After Vertical Sleeve Gastrectomy and Gastric Bypass

et al. 2021

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“…Another retrospective observational study showed no differences between gastric bariatric surgery and sleeve gastrectomy regarding re-interventions or obstetric outcomes [ 4 ]. Conflicting evidence exists on the possible adverse effects of sleeve gastrectomy such as dyspepsia and weight regain as compared with gastric bariatric surgery [ 47 – 49 ]. Our study adds important knowledge about the different surgical procedures, suggesting that gastric bariatric surgery holds greater risk of vitamin K1 deficiency compared with sleeve gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study

Bechensteen,

Sithiravel,

Strøm-Roum

et al. 2024

BMC Pregnancy Childbirth

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Background Maternal obesity is associated with adverse outcome for pregnancy and childbirths. While bariatric surgery may improve fertility and reduce the risk of certain pregnancy-related complications such as hypertension and gestational diabetes mellitus, there is a lack of evidence on the optimal nutritional monitoring and supplementation strategies in pregnancy following bariatric surgery. We aimed to assess the impact of bariatric surgery on micronutrients in post-bariatric pregnancy and possible differences between gastric bypass surgery and sleeve gastrectomy. Methods In this prospective case control study, we recruited 204 pregnant women (bariatric surgery n = 59 [gastric bypass surgery n = 26, sleeve gastrectomy n = 31, missing n = 2] and controls n = 145) from Akershus university hospital in Norway. Women with previous bariatric surgery were consecutively invited to study participation at referral to the clinic for morbid obesity and the controls were recruited from the routine ultrasound screening in gestational week 17–20. A clinical questionnaire was completed and blood samples were drawn at mean gestational week 20.4 (SD 4.5). Results The women with bariatric surgery had a higher pre-pregnant BMI than controls (30.8 [SD 6.0] vs. 25.2 [5.4] kg/m2, p < 0.001). There were no differences between groups regarding maternal weight gain (bariatric surgery 13.3 kg (9.6) vs. control 14.8 kg (6.5), p = 0.228) or development of gestational diabetes (n = 3 [5%] vs. n = 7 [5%], p = 1.000). Mean levels of vitamin K1 was lower after bariatric surgery compared with controls (0.29 [0.35] vs. 0.61 [0.65] ng/mL, p < 0.001). Multiadjusted regression analyses revealed an inverse relationship between bariatric surgery and vitamin K1 (B -0.26 ng/mL [95% CI -0.51, -0.04], p = 0.047) with a fivefold increased risk of vitamin K1 deficiency in post-bariatric pregnancies compared with controls (OR 5.69 [1.05, 30.77] p = 0.044). Compared with sleeve gastrectomy, having a previous gastric bypass surgery was associated with higher risk of vitamin K1 deficiency (OR 17.1 [1.31, 223.3], p = 0.030). Conclusion Post-bariatric pregnancy is negatively associated with vitamin K1 with a higher risk of vitamin K1 deficiency in pregnancies after gastric bypass surgery compared with after sleeve gastrectomy. Vitamin K1 deficiency in post-bariatric pregnancy have potential risk of hypocoaguble state in mother and child and should be explored in future studies.

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“…Obesity has been regarded as a significant risk factor for developing gastroesophageal reflux disease (GERD), accounting for more than 50% of people showing mild or severe symptoms [1]. It has been reported that obesity and its related comorbidities reduce the quality of life and life expectancy [2].…”

Section: Introductionmentioning

confidence: 99%

Symptomatic GERD after Sleeve Gastrectomy

Azzam S

2023

Int J Surg Res Pract

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Background: Laparoscopic sleeve gastrectomy (LSG) remains an effective standalone bariatric surgery. Some patients might experience gastroesophageal reflux (GERD) symptoms post LSG despite its beneficial outcome on weight loss and improving obesity morbidities. This study aims to determine the prevalence of post-LSG GERD symptoms and associated risk factors. Subjects and methods:This study comprises LSG patients who underwent surgery between 2015 to 2020. We applied the GERD-Health-Related Quality of Life (GERD-HRQL) questionnaire to compute the prevalence of GERD symptoms before and after surgery. The answer was rated from 0 to 5 based on GERD symptoms severity.Results: A total of 160 patients (mean age: 33.8 ± 11.15 years: 63% of female) were included. The mean preoperative and postoperative weights were 133.5 ± 28.21 Kg (BMI 44.86 kg/m2) and 83.32 ± 21.23 Kg, respectively, with the average excess weight loss (EWL) of 69.5% after LSG. The Wilcoxon Signed Ranks test has shown increased GERD symptoms in previous GERD free or mildly symptomatic patients. Conclusion:LSG was significantly associated with the new onset of GERD symptoms and worsened the mild preoperative symptoms.

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The Effect of Laparoscopic Sleeve Gastrectomy on Gastroesophageal Reflux Disease

Cited by 17 publications

References 15 publications

Gastroesophageal Reflux Disease Outcomes After Vertical Sleeve Gastrectomy and Gastric Bypass

Gastroesophageal Reflux Disease Outcomes After Vertical Sleeve Gastrectomy and Gastric Bypass

Post-bariatric pregnancy is associated with vitamin K1 deficiency, a case control study

Symptomatic GERD after Sleeve Gastrectomy

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