Abstract
Background
One of the most controversial issues surrounding laparoscopic sleeve gastrectomy is
the development of gastroesophageal reflux disease following surgery. The aim of the
study was to evaluate the occurrence of gastroesophageal reflux disease after laparoscopic
sleeve gastrectomy and to analyze patients’ weight loss, comorbidities, and quality
of life after surgery.
Methods
The clinical records of 52 patients submitted to laparoscopic sleeve gastrectomy between
January and November 2018, with 3 years of follow-up, were retrospectively reviewed.
At the end of the follow-up period, the patients underwent screening endoscopy, and
those with postoperative esophagitis were submitted to endoscopic biopsies and pH-impedance
monitoring (MII-pH). The presence of gastroesophageal reflux disease symptoms was
assessed using the modified clinical DeMesteer score questionnaire. The Bariatric
Analysis and Reporting Outcome System score and 36-Item Short Form Health Survey were
used to assess the postoperative quality of life.
Results
In the preoperative work-up, only 7.6% of patients had signs of esophagitis at esophagogastroduodenoscopy,
whilst at 3-year follow-up, 50% of them had endoscopic signs of gastroesophageal reflux
disease. Twenty-one out of 26 patients with signs of esophagitis agreed to undergo
MII-pH. The median DeMesteer score questionnaire was 4.5, with only 4 patients (19%)
exhibiting a value greater than the pH cut-off value (14.72), indicative of gastroesophageal
reflux disease. MII-pH data analysis showed the presence of gastroesophageal reflux
disease in 5 patients. An excellent outcome on the Bariatric Analysis and Reporting Outcome System score was reported
in 50% of patients, and all 8 domains from the 36-Item Short Form Health Survey improved
significantly.
Conclusion
This study showed an improvement in these patients’ quality of life and the limited
refluxogenic nature of laparoscopic sleeve gastrectomy at 3-year follow-up when diagnosis
of gastroesophageal reflux disease is based on the Lyon consensus.
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Article info
Publication history
Published online: July 02, 2022
Accepted:
April 29,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
