Roux-en-Y gastric bypass as a salvage solution for severe and refractory gastroparesis in malnourished patients.
Surg Obes Relat Dis
; 18(5): 577-580, 2022 05.
Article
em En
| MEDLINE
| ID: mdl-35221251
ABSTRACT
BACKGROUND:
Gastroparesis (GP) is a rare condition for which several symptomatic treatments are available, but they may fail, leading to a discussion of gastrectomy. Few studies have described gastric-preserving surgery, particularly in malnourished patients.OBJECTIVE:
To describe the treatment of severe refractory GP with Roux-en-Y gastric bypass (RYGB).SETTING:
A university center.METHODS:
A retrospective review was conducted of adult patients who underwent laparoscopic RYGB. Severity and frequency of GP symptoms were compared before and 1 year after surgery using the Gastroparesis Cardinal Symptom Index (GCSI) score (0-5), the vomiting (VM) score (0-4), and the visual analog scale (VAS) for abdominal pain.RESULTS:
Of the 9 patients with refractory GP, 7 were malnourished and 2 had obesity. There were no postoperative deaths. One patient was operated on for internal hernia without bowel necrosis. The mean GCSI score decreased significantly from 3.6 (range 1-5) preoperatively to 2.1 (range .3-4.4) postoperatively (P = .0019). The mean VM score improved significantly after surgery, from .22 (range 0-1 units) preoperatively to 2.55 (range 1-4) postoperatively (P = .007). The mean VAS score also decreased significantly from 7.0 (range 5-9) preoperatively to 2.44 (range 0-7) postoperatively (P = .0015). A nonsignificant weight and albumin change was observed at 1 year postoperatively, with a tendency for weight regain in malnourished patients.CONCLUSION:
In malnourished patients with severe and refractory GP, this study suggests the feasibility, safety, and efficacy of RYGB for the treatment of vomiting and abdominal pain.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Obesidade Mórbida
/
Derivação Gástrica
/
Laparoscopia
/
Gastroparesia
/
Desnutrição
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Adult
/
Humans
Idioma:
En
Revista:
Surg Obes Relat Dis
Assunto da revista:
METABOLISMO
Ano de publicação:
2022
Tipo de documento:
Article