Update: 10 Years of Sleeve Gastrectomy—the First 103 Patients

Felsenreich, Daniel Moritz; Ladinig, Lukas M; Beckerhinn, Philipp; Sperker, Christoph; Schwameis, Katrin; Krebs, Michael; Jedamzik, Julia; Eilenberg, Magdalena; Bichler, Christoph; Prager, Gerhard; Langer, Felix B.

doi:10.1007/s11695-018-3399-1

Cited by 92 publications

(56 citation statements)

References 31 publications

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“…Burgerhart et al reported similar weight loss after 3 months [14]. Weight loss was reported to occur in the early period and decrease after the second year, after which weight was regained [15]. However, as only early-period data were available, it is not possible to make such a conclusion in the current study.…”

Section: Discussionmentioning

confidence: 48%

“…There are many examples of a significant increase in the DeMeester score with 24-h pH monitoring [21,29,30]. Nevertheless, there are also studies that have reported no change or even a decrease in the score [15,24]. Of the parameters forming the DeMeester score, no significant increase was seen in the total number of reflux episodes, whereas the total number of reflux episodes longer than 5 min was found to have the greatest effect.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes of laparoscopic sleeve gastrectomy by means of esophageal manometry and pH-metry, before and after surgery

Gemici¹,

Köneş²,

Seyit³

et al. 2020

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Section: Discussionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 99%

Outcomes of laparoscopic sleeve gastrectomy by means of esophageal manometry and pH-metry, before and after surgery

Gemici¹,

Köneş²,

Seyit³

et al. 2020

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“…Taken together, 76.2% had at least borderline evidence of GERD with 4.8% of individuals presenting with Barrett's esophagus, which is alarming as the current data illustrate that a large percentage of de novo GERD after sleeve gastrectomy, one of the leading bariatric procedures worldwide, derives from silent preoperative reflux [30]. Based on this, adverse long-term data revealing considerable conversion rates due to GERD-related complications seem understandable [5]. Although data were collected prospectively, analysis of parameters was conducted retrospectively; thus, potential selection bias was minimized by consecutive inclusion of patients.…”

Section: Discussionmentioning

confidence: 83%

“…Currently, sleeve gastrectomy (SG) is the leading bariatric procedure in the USA and western world [4]. Recently presented long-term data show a high incidence of hiatal hernia, gastroesophageal reflux disease (GERD), and Barrett's esophagus in patients after SG [5]. As a consequence, some authors even suggest that preexisting GERD should be a relative contraindication to SG.…”

Section: Introductionmentioning

confidence: 99%

Modern Esophageal Function Testing and Gastroesophageal Reflux Disease in Morbidly Obese Patients

et al. 2019

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Background The implementation of high-resolution manometry (HRM) and the Lyon Consensus statement facilitate evaluation of gastroesophageal reflux disease and motility disorders in morbidly obese patients. Therefore, we aimed to investigate prevalence and phenotype of (borderline) GERD and esophageal motility disorders in this population. Methods Consecutive morbidly obese (BMI ≥ 35 kg/m 2 ) patients were offered evaluation by means of HRM, ambulatory 24-h pH impedance monitoring, endoscopy, and a clinical examination at our tertiary academic center. Data were collected prospectively.Results Out of 448 eligible individuals, 147 patients (females = 75, 51%) with a median age of 41.6 (33.4; 52.3) years and a BMI of 44 (40.9; 49.4) kg/m 2 were included during the study period. The Chicago Classification revealed motility disorders in 50 (34%) patients, dominated by outflow obstruction (18.4%, n = 27) and a novel disorder (7.5%, n = 11), nicknamed jackhammer esophagus (JE). According to the Lyon Consensus, 52 (35.4%) patients had evidence of true GERD, whereas borderline GERD was noted in another 60 (40.8%). Hypersensitive esophagus was observed in 6.8% (n = 10). Sensitivity and specificity of symptoms for GERD were 53.8% and 68.4%, respectively. Conclusions The current gold standard of assessment revealed that the prevalence of esophageal motility disorders and (borderline) GERD is high in the morbidly obese population. Further longitudinal data are needed to delineate the natural course of novel motility disorders like JE in obesity and to identify risk factors for adverse outcomes following bariatric surgery.

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“…While research has shown many times that SG is highly efficient in achieving weight loss in short-and midterm follow-up periods [2][3][4], a few long-term studies quite recently have also found that a significant number of SG patients do suffer from reflux and weight regain in a long-term follow-up. Some of them may develop esophagitis and even Barrett's esophagus (BE) [5][6][7]. These studies have also shown that a large percentage of patients were in need of a conversion to a different bariatric procedure [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Roux-en-Y Gastric Bypass as a Treatment for Barrett’s Esophagus after Sleeve Gastrectomy

et al. 2019

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Background Laparoscopic sleeve gastrectomy (SG) is the most frequently performed bariatric procedure today. While an increasing number of long-term studies report the occurrence of Barrett's esophagus (BE) after SG, its treatment has not been studied, yet. Objectives The aim of this study was to evaluate Roux-en-Y gastric bypass (RYGB) as treatment for BE and reflux after SG. Setting University hospital setting, Austria Methods This multi-center study includes all patients (n = 10) that were converted to RYGB due to BE after SG in Austria. The mean interval between SG and RYGB was 42.7 months. The follow-up after RYGB in this study was 33.4 months. Gastroscopy, 24 h pH-metry, and manometry were performed and patients were asked to complete the BAROS and GIQLI questionnaires. Results Weight and BMI at the time of SG was 120.8 kg and 45.1 kg/m 2. Eight patients (80.0%) went into remission of BE after the conversion to RYGB. Two patients had RYGB combined with hiatoplasty. The mean acid exposure time in 24 h decreased from 36.8 to 3.8% and the mean DeMeester score from 110.0 to 16.3. Patients scored 5.1 on average in the BAROS after conversion from SG to RYGB which denotes a very good outcome. Conclusions RYGB is an effective therapy for patients with BE and reflux after SG. Its outcomes in the current study were BE remission in the majority of cases as well as a decrease in reflux activity. Further studies with larger cohorts are necessary to confirm these findings.

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Update: 10 Years of Sleeve Gastrectomy—the First 103 Patients

Abstract: The authors recommend gastroscopies at 5-year intervals after SG to detect the possible sequelae of reflux at an early stage. Conversion to Roux-en-Y-gastric bypass (RYGB) works well to cure patients from reflux but may not be as efficient at treating weight regain.

Cited by 92 publications

References 31 publications

Outcomes of laparoscopic sleeve gastrectomy by means of esophageal manometry and pH-metry, before and after surgery

Outcomes of laparoscopic sleeve gastrectomy by means of esophageal manometry and pH-metry, before and after surgery

Modern Esophageal Function Testing and Gastroesophageal Reflux Disease in Morbidly Obese Patients

Roux-en-Y Gastric Bypass as a Treatment for Barrett’s Esophagus after Sleeve Gastrectomy

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