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Long-term risk of adult overweight and obesity among achalasia patients who underwent Heller Myotomy.
Perez-Ortiz, Andric C; Narváez-Chávez, Sofia; Furuzawa-Carballeda, Janette; Coss-Adame, Enrique; Valdovinos-Díaz, Miguel A; Peralta-Figueroa, José; Olvera-Prado, Hector; López-Verdugo, Fidel; Sánchez-García Ramos, Emilio; Torres-Villalobos, Gonzalo.
Affiliation
  • Perez-Ortiz AC; Department of Experimental Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
  • Narváez-Chávez S; Escuela de Medicina, Universidad Panamericana, Ciudad de México, México.
  • Furuzawa-Carballeda J; Division of Surgery, Massachusetts General Hospital, Boston, MA, USA.
  • Coss-Adame E; Department of Experimental Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
  • Valdovinos-Díaz MA; Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
  • Peralta-Figueroa J; Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
  • Olvera-Prado H; Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
  • López-Verdugo F; Department of Experimental Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
  • Sánchez-García Ramos E; Department of Experimental Surgery, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
  • Torres-Villalobos G; Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Neurogastroenterol Motil ; 32(10): e13921, 2020 10.
Article in En | MEDLINE | ID: mdl-32557989
BACKGROUND: It is unknown whether surgically treated achalasia cases regain or surpass their usual weight into obesity or overweight in the long-term post-operative period. Here, we aimed to assess the incidence of overweight/obesity (Ob/Ow) and the risk for reoccurrence up to 48 months post-laparoscopic Heller myotomy (LHM). METHODS: We performed a cohort of 114 achalasia cases undergoing LHM. All patients had a confirmed diagnosis of achalasia and had no added comorbidities. We followed up the body mass index (BMI) at the immediate post-operative period, and at one-, six-, 12-, 24-, and 48 months after LHM. We measured the incidence of Ob/Ow and its reoccurrence risk with Cox regression. KEY RESULTS AND CONCLUSIONS: In the immediate post-operative period, the incidence of Ob/Ow was significantly less than the usual BMI (before the onset of symptoms) (28.2% vs 66.3%). From the sixth to the 48th month, there was a progressive increase in the incidence of Ob/Ow and at this timepoint the percent of Ob/Ow was not statistically different from the usual BMI. The most significant hazard for Ob/Ow reoccurrence in the long term following LHM is a usual BMI with obesity grade I or III and males lacking pre-surgical weight loss. INFERENCES: Achalasia cases undergoing surgical treatment should be monitored closely in the post-operative period for weight regain, regardless of their pre-operative BMI. Notably, males who before the onset of symptoms were obese or overweight are at significantly increased risk of regaining or surpassing their weight, despite most having lost weight pre-surgically.
Subject(s)
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Postoperative Care / Esophageal Achalasia / Overweight / Heller Myotomy / Body-Weight Trajectory Type of study: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Neurogastroenterol Motil Journal subject: GASTROENTEROLOGIA / NEUROLOGIA Year: 2020 Document type: Article Affiliation country: Mexico Country of publication: United kingdom

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Postoperative Care / Esophageal Achalasia / Overweight / Heller Myotomy / Body-Weight Trajectory Type of study: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Neurogastroenterol Motil Journal subject: GASTROENTEROLOGIA / NEUROLOGIA Year: 2020 Document type: Article Affiliation country: Mexico Country of publication: United kingdom