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Outcomes of Conversion from Sleeve Gastrectomy to Roux-en-Y Gastric Bypass Due to GERD-a Retrospective Analysis of 35 Patients.
Curell, Anna; Beisani, Marc; García Ruiz de Gordejuela, Amador; Vilallonga, Ramon; Verdaguer Tremolosa, Mireia; González López, Óscar; Caubet Busquet, Enric; Fort López-Barajas, José Manuel.
Afiliação
  • Curell A; General and Digestive Surgery Department, Vall d'Hebron Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain.
  • Beisani M; Vall d'Hebron Research Institute (VHIR), Barcelona, Spain.
  • García Ruiz de Gordejuela A; Bariatric Surgery Unit, General and Digestive Surgery Department, Moises Broggi Hospital, CSI, Sant Joan Despi, Barcelona, Spain.
  • Vilallonga R; Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Vall d'Hebron Hospital Campus, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • Verdaguer Tremolosa M; Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Vall d'Hebron Hospital Campus, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
  • González López Ó; General and Digestive Surgery Department, Vall d'Hebron Hospital Campus, Universitat Autònoma de Barcelona, Barcelona, Spain.
  • Caubet Busquet E; Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Vall d'Hebron Hospital Campus, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain. 40667ogl@gmail.com.
  • Fort López-Barajas JM; Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Vall d'Hebron Hospital Campus, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Passeig Vall d'Hebron 119-129, 08035, Barcelona, Spain.
Obes Surg ; 31(9): 4100-4106, 2021 09.
Article em En | MEDLINE | ID: mdl-34227017
ABSTRACT

BACKGROUND:

Sleeve gastrectomy (SG) has become one of the most performed bariatric procedures worldwide. Its main weaknesses are weight regain and gastroesophageal reflux disease (GERD). Conversion to Roux-en-Y gastric bypass (RYGB) is considered the gold standard to manage GERD and related symptoms.

METHODS:

Retrospective evaluation from a prospective bariatric surgery database of all our institution's patients converted from SG to RYGB due to GERD between January 2010 and December 2018. Clinical characteristics and workups before SG and before and after RYGB were analyzed.

RESULTS:

During the study period, 35 patients needed a conversion to RYGB, due to GERD or GERD-related symptoms. Mean age was 48.6 years, 85.7% were women, and mean BMI was 31.4 kg/m2. The interval between SG and RYGB was in a range 7 to 70 months (mean 33 months). All conversions were completed laparoscopically, associating a hiatoplasty in 45.7% of cases. A complete remission of symptoms was observed in 74% of patients, some improvement in 20%, and no relief in 6%. There were 3 cases of hiatal hernia persistence and 2 of recidivism. Only 1 patient presented pathological pHmetry, while moderate esophagitis was demonstrated in 2 patients.

CONCLUSIONS:

Conversion to RYGB was effective in almost all patients. Pathological acid exposure and hiatal hernias seem to be the main findings prior to conversion, justifying an exhaustive examination and aggressive approach to the hiatus. Due to the insufficient correlation between symptoms and findings on morphological and functional tests, actively searching for signs of GERD is advisable.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Obesidade Mórbida / Derivação Gástrica / Refluxo Gastroesofágico Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Female / Humans / Middle aged Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Obesidade Mórbida / Derivação Gástrica / Refluxo Gastroesofágico Tipo de estudo: Etiology_studies / Observational_studies / Risk_factors_studies Limite: Female / Humans / Middle aged Idioma: En Ano de publicação: 2021 Tipo de documento: Article