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GERD-screening before bariatric surgery: the predictive value of the GERD-HRQL questionnaire score compared with preoperative EGD findings.
Allotey, Jonathan; Caposole, Michael; Attia, Abdallah; Coonan, Erin; Noguera, Valeria; Lewis, Emma; Bloomenthal, Molly S; Issa, Peter; Omar, Mahmoud; Aboueisha, Mohamed; Crisp, Benjamin; Baker, John; Levy, Shauna; Galvani, Carlos.
Afiliação
  • Allotey J; Division of Bariatric and MIS, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
  • Caposole M; Division of Bariatric and MIS, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
  • Attia A; Division of Bariatric and MIS, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
  • Coonan E; Division of Bariatric and MIS, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
  • Noguera V; Division of Bariatric and MIS, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
  • Lewis E; Division of Bariatric and MIS, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
  • Bloomenthal MS; Division of Bariatric and MIS, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
  • Issa P; Louisiana State University Health Sciences Center School of Medicine, New Orleans, LA, USA.
  • Omar M; Division of Bariatric and MIS, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
  • Aboueisha M; Division of Otolaryngology- Head and Neck Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA.
  • Crisp B; Division of Bariatric and MIS, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
  • Baker J; Division of Bariatric and MIS, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
  • Levy S; Division of Bariatric and MIS, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
  • Galvani C; Division of Bariatric and MIS, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA. carlosgalvani@yahoo.com.
Surg Endosc ; 37(12): 9572-9581, 2023 12.
Article em En | MEDLINE | ID: mdl-37730853
BACKGROUND: There is an ongoing debate on how to best identify patients with gastroesophageal reflux disease (GERD) before bariatric surgery. The value of routine preoperative esophagogastroduodenoscopy (EGD) is questioned, and patient reported symptoms are commonly used for screening. The goal of this study is to determine if patient reported symptoms using a validated questionnaire correlate with preoperative EGD findings. METHODOLOGY: A prospective cohort study at a single institution was performed. Patients undergoing bariatric surgery between December 2020 and March 2023 were required to report symptoms of reflux by completing a preoperative GERD. Health-Related Quality of Life (GERD-HRQL) questionnaire and undergo a mandatory preoperative screening EGD. Patients were stratified into two cohorts: (group A) asymptomatic (score = 0) and (group B) symptomatic (score > 0). Statistical analysis was conducted using Pearson's chi-squared test and Wilcoxon rank-sum test in RStudio version 4.2.2. The predictive value of the GERD-HRQL score was analyzed using Areas Under the Curve (AUC; AUC = 0.5 not predictive, 0.5 < AUC ≥ 6 poor prediction & AUC > 0.9 excellent prediction) calculated from Receiver Operating Characteristic (ROC) curves. RESULTS: 200 patients were included; median age was 42.0 years (IQR 36.0 to 49.2). There were 79 patients (39.5%) in Group A and 121 patients (60.5%) in Group B. There was no difference in the frequency esophagitis (27.8% vs 32.2%, p = 0.61) or hiatal hernias (49.4% vs 47.1%, p = 0. 867) between group A and group B, respectively. ROC analysis revealed that the total GERD HRQL scores, heartburn only scores and regurgitation only scores, were poor predictors of esophagitis found on EGD (AUC 0.52, 0.53, 0.52), respectively. In asymptomatic patients, higher BMI was significantly associated with esophagitis (OR 1.15, 95% CI 1.06-1.27, p = 0.002). CONCLUSION: Symptoms, identified through the GERD-HRQL questionnaire, are a poor indicator of esophagitis or its severity in patients undergoing workup for bariatric surgery. Therefore, liberal screening upper endoscopy is recommended for pre-bariatric surgery patients to guide appropriate procedure selection.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Refluxo Gastroesofágico / Esofagite / Cirurgia Bariátrica Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies / Screening_studies Limite: Adult / Humans Idioma: En Revista: Surg Endosc Assunto da revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Refluxo Gastroesofágico / Esofagite / Cirurgia Bariátrica Tipo de estudo: Diagnostic_studies / Observational_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies / Screening_studies Limite: Adult / Humans Idioma: En Revista: Surg Endosc Assunto da revista: DIAGNOSTICO POR IMAGEM / GASTROENTEROLOGIA Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos