WHEN SHOULD BE CONVERTED LAPAROSCOPIC SLEEVE GASTRECTOMY TO LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS DUE TO GASTROESOPHAGEAL REFLUX?

Detalhes bibliográficos
Autor(a) principal: BRAGHETTO,Italo
Data de Publicação: 2020
Outros Autores: KORN,Owen, BURGOS,Anamaría, FIGUEROA,Manuel
Tipo de documento: Artigo
Idioma: eng
Título da fonte: ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202020000400304
Resumo: ABSTRACT Background: Gastroesophageal reflux (GER) is one of the most common indications for conversion of sleeve gastrectomy (LSG) to laparoscopic Roux-en-Y gastric bypass (LRYGBP). Objective evaluations are necessary in order to choose the best definitive treatment for these patients. Aim: To present and describe the findings of the objective studies for gastroesophageal reflux disease performed before LSG conversion to LRYGBP in order to support the indication for surgery. Method: Thirty-nine non-responder patients to proton pump inhibitors treatment after LSG were included in this prospective study. They did not present GER symptoms, esophagitis or hiatal hernia before LSG. Endoscopy, radiology, manometry, 24 h pH monitoring were performed. Results: The mean time of appearance of reflux symptoms was 26.8+24.08 months (8-71). Erosive esophagitis was found in 33/39 symptomatic patients (84.6%) and Barrett´s esophagus in five. (12.8%). Manometry and acid reflux test were performed in 38/39 patients. Defective lower esophageal sphincter function was observed independent the grade of esophagitis or Barrett´s esophagus. Pathologic acid reflux with elevated DeMeester´s scores and % of time pH<4 was detected in all these patients. more significant in those with severe esophagitis and Barrett´s esophagus. Radiologic sleeve abnormalities were observed in 35 patients, mainly cardia dilatation (n=18) and hiatal hernia (n=11). Middle gastric stricture was observed in only six patients. Conclusion: Patients with reflux symptoms and esophagitis or Barrett´s esophagus after SG present defective lower esophageal sphincter function and increased acid reflux. These conditions support the indication of conversion to LRYGBP.
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spelling WHEN SHOULD BE CONVERTED LAPAROSCOPIC SLEEVE GASTRECTOMY TO LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS DUE TO GASTROESOPHAGEAL REFLUX?Sleeve gastrectomyGastroesophageal refluxGastric bypassABSTRACT Background: Gastroesophageal reflux (GER) is one of the most common indications for conversion of sleeve gastrectomy (LSG) to laparoscopic Roux-en-Y gastric bypass (LRYGBP). Objective evaluations are necessary in order to choose the best definitive treatment for these patients. Aim: To present and describe the findings of the objective studies for gastroesophageal reflux disease performed before LSG conversion to LRYGBP in order to support the indication for surgery. Method: Thirty-nine non-responder patients to proton pump inhibitors treatment after LSG were included in this prospective study. They did not present GER symptoms, esophagitis or hiatal hernia before LSG. Endoscopy, radiology, manometry, 24 h pH monitoring were performed. Results: The mean time of appearance of reflux symptoms was 26.8+24.08 months (8-71). Erosive esophagitis was found in 33/39 symptomatic patients (84.6%) and Barrett´s esophagus in five. (12.8%). Manometry and acid reflux test were performed in 38/39 patients. Defective lower esophageal sphincter function was observed independent the grade of esophagitis or Barrett´s esophagus. Pathologic acid reflux with elevated DeMeester´s scores and % of time pH<4 was detected in all these patients. more significant in those with severe esophagitis and Barrett´s esophagus. Radiologic sleeve abnormalities were observed in 35 patients, mainly cardia dilatation (n=18) and hiatal hernia (n=11). Middle gastric stricture was observed in only six patients. Conclusion: Patients with reflux symptoms and esophagitis or Barrett´s esophagus after SG present defective lower esophageal sphincter function and increased acid reflux. These conditions support the indication of conversion to LRYGBP.Colégio Brasileiro de Cirurgia Digestiva2020-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0102-67202020000400304ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.33 n.4 2020reponame:ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)instname:Colégio Brasileiro de Cirurgia Digestiva (CBCD)instacron:CBCD10.1590/0102-672020200004e1553info:eu-repo/semantics/openAccessBRAGHETTO,ItaloKORN,OwenBURGOS,AnamaríaFIGUEROA,Manueleng2021-01-21T00:00:00Zoai:scielo:S0102-67202020000400304Revistahttp://abarriguda.org.br/revista/index.php/revistaabarrigudaarepb/indexONGhttps://old.scielo.br/oai/scielo-oai.php||revistaabcd@gmail.com2317-63262317-6326opendoar:2021-01-21T00:00ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) - Colégio Brasileiro de Cirurgia Digestiva (CBCD)false
dc.title.none.fl_str_mv WHEN SHOULD BE CONVERTED LAPAROSCOPIC SLEEVE GASTRECTOMY TO LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS DUE TO GASTROESOPHAGEAL REFLUX?
title WHEN SHOULD BE CONVERTED LAPAROSCOPIC SLEEVE GASTRECTOMY TO LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS DUE TO GASTROESOPHAGEAL REFLUX?
spellingShingle WHEN SHOULD BE CONVERTED LAPAROSCOPIC SLEEVE GASTRECTOMY TO LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS DUE TO GASTROESOPHAGEAL REFLUX?
BRAGHETTO,Italo
Sleeve gastrectomy
Gastroesophageal reflux
Gastric bypass
title_short WHEN SHOULD BE CONVERTED LAPAROSCOPIC SLEEVE GASTRECTOMY TO LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS DUE TO GASTROESOPHAGEAL REFLUX?
title_full WHEN SHOULD BE CONVERTED LAPAROSCOPIC SLEEVE GASTRECTOMY TO LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS DUE TO GASTROESOPHAGEAL REFLUX?
title_fullStr WHEN SHOULD BE CONVERTED LAPAROSCOPIC SLEEVE GASTRECTOMY TO LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS DUE TO GASTROESOPHAGEAL REFLUX?
title_full_unstemmed WHEN SHOULD BE CONVERTED LAPAROSCOPIC SLEEVE GASTRECTOMY TO LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS DUE TO GASTROESOPHAGEAL REFLUX?
title_sort WHEN SHOULD BE CONVERTED LAPAROSCOPIC SLEEVE GASTRECTOMY TO LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS DUE TO GASTROESOPHAGEAL REFLUX?
author BRAGHETTO,Italo
author_facet BRAGHETTO,Italo
KORN,Owen
BURGOS,Anamaría
FIGUEROA,Manuel
author_role author
author2 KORN,Owen
BURGOS,Anamaría
FIGUEROA,Manuel
author2_role author
author
author
dc.contributor.author.fl_str_mv BRAGHETTO,Italo
KORN,Owen
BURGOS,Anamaría
FIGUEROA,Manuel
dc.subject.por.fl_str_mv Sleeve gastrectomy
Gastroesophageal reflux
Gastric bypass
topic Sleeve gastrectomy
Gastroesophageal reflux
Gastric bypass
description ABSTRACT Background: Gastroesophageal reflux (GER) is one of the most common indications for conversion of sleeve gastrectomy (LSG) to laparoscopic Roux-en-Y gastric bypass (LRYGBP). Objective evaluations are necessary in order to choose the best definitive treatment for these patients. Aim: To present and describe the findings of the objective studies for gastroesophageal reflux disease performed before LSG conversion to LRYGBP in order to support the indication for surgery. Method: Thirty-nine non-responder patients to proton pump inhibitors treatment after LSG were included in this prospective study. They did not present GER symptoms, esophagitis or hiatal hernia before LSG. Endoscopy, radiology, manometry, 24 h pH monitoring were performed. Results: The mean time of appearance of reflux symptoms was 26.8+24.08 months (8-71). Erosive esophagitis was found in 33/39 symptomatic patients (84.6%) and Barrett´s esophagus in five. (12.8%). Manometry and acid reflux test were performed in 38/39 patients. Defective lower esophageal sphincter function was observed independent the grade of esophagitis or Barrett´s esophagus. Pathologic acid reflux with elevated DeMeester´s scores and % of time pH<4 was detected in all these patients. more significant in those with severe esophagitis and Barrett´s esophagus. Radiologic sleeve abnormalities were observed in 35 patients, mainly cardia dilatation (n=18) and hiatal hernia (n=11). Middle gastric stricture was observed in only six patients. Conclusion: Patients with reflux symptoms and esophagitis or Barrett´s esophagus after SG present defective lower esophageal sphincter function and increased acid reflux. These conditions support the indication of conversion to LRYGBP.
publishDate 2020
dc.date.none.fl_str_mv 2020-01-01
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dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv 10.1590/0102-672020200004e1553
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dc.publisher.none.fl_str_mv Colégio Brasileiro de Cirurgia Digestiva
publisher.none.fl_str_mv Colégio Brasileiro de Cirurgia Digestiva
dc.source.none.fl_str_mv ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) v.33 n.4 2020
reponame:ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
instname:Colégio Brasileiro de Cirurgia Digestiva (CBCD)
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instname_str Colégio Brasileiro de Cirurgia Digestiva (CBCD)
instacron_str CBCD
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reponame_str ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)
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repository.name.fl_str_mv ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) - Colégio Brasileiro de Cirurgia Digestiva (CBCD)
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