Sukaina Jaffar1, Michael Devadas2,3,4,5,6,7. 1. Department of Upper Gastrointestinal Surgery and General Surgery, Nepean Hospital, Nepean Blue Mountains Local Health District, Sydney, NSW, Australia. Jaffar.su@gmail.com. 2. Department of Upper Gastrointestinal Surgery and General Surgery, Nepean Hospital, Nepean Blue Mountains Local Health District, Sydney, NSW, Australia. 3. Department of Bariatric Surgery and Upper Gastrointestinal Surgery, Blacktown Hospital, Western Sydney Local Health District, Sydney, NSW, Australia. 4. Centre for Bariatric and Metabolic Surgery, Circle of Care - Institute of Weight Control, Hospital for Specialist Surgery, Sydney, NSW, Australia. 5. Department of Upper Gastrointestinal Surgery and General Surgery, Nepean Private Hospital, Sydney, NSW, Australia. 6. Department of Upper Gastrointestinal Surgery and General Surgery, Norwest Private Hospital, Sydney, NSW, Australia. 7. Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
Abstract
INTRODUCTION/AIMS: There is paucity of literature examining dysphagia after laparoscopic sleeve gastrectomy (LSG). Moreover, there are few validated scoring systems for dysphagia that adequately assess its psychosocial impact. We aim to investigate dysphagia after LSG using a multidimensional scale that examines its functional and emotional impact. As secondary aims, we evaluated the impact of dysphagia on weight outcomes and its relationship with pre-operative gastro-esophageal reflux disease (GERD) and proton pump inhibitor (PPI) use. METHODS: One hundred twenty-four patients 1 year or more post-LSG were administered the validated Dysphagia Handicap Index (DHI) questionnaire. To further delineate esophageal dysphagia, three additional questions were added. One hundred one patients (81.5%) responded. Physical, Emotional, Functional, and Esophageal scales were analyzed combined and individually using a multivariate model. RESULTS: No patients reported dysphagia pre-operatively. The median DHI scale scores are the following: Physical-2 (0-20); Functional-4 (0-22); Emotional-2 (0-14); and Esophageal-2 (0-8). On multivariate analysis, DHI Emotional scores significantly correlated with reduced total weight loss (%TWL) (p = 0.001) and excess weight loss (%EWL) (p = 0.023). The physical symptoms of dysphagia did not affect weight outcomes. Post-operatively, PPI usage increased significantly (15.8 vs 19.8%, p = 0.01) and correlated with higher dysphagia scores. CONCLUSION: A statistically validated dysphagia-specific questionnaire was utilized to evaluate the impact of LSG on dysphagia including its functional and emotional influences. The psychosocial handicap of dysphagia significantly reduced weight loss outcomes. A correlation between PPI use and dysphagia after LSG was found. The prevalence of dysphagia after LSG and the factors that contribute to its symptoms need to be further studied.
INTRODUCTION/AIMS: There is paucity of literature examining dysphagia after laparoscopic sleeve gastrectomy (LSG). Moreover, there are few validated scoring systems for dysphagia that adequately assess its psychosocial impact. We aim to investigate dysphagia after LSG using a multidimensional scale that examines its functional and emotional impact. As secondary aims, we evaluated the impact of dysphagia on weight outcomes and its relationship with pre-operative gastro-esophageal reflux disease (GERD) and proton pump inhibitor (PPI) use. METHODS: One hundred twenty-four patients 1 year or more post-LSG were administered the validated Dysphagia Handicap Index (DHI) questionnaire. To further delineate esophageal dysphagia, three additional questions were added. One hundred one patients (81.5%) responded. Physical, Emotional, Functional, and Esophageal scales were analyzed combined and individually using a multivariate model. RESULTS: No patients reported dysphagia pre-operatively. The median DHI scale scores are the following: Physical-2 (0-20); Functional-4 (0-22); Emotional-2 (0-14); and Esophageal-2 (0-8). On multivariate analysis, DHI Emotional scores significantly correlated with reduced total weight loss (%TWL) (p = 0.001) and excess weight loss (%EWL) (p = 0.023). The physical symptoms of dysphagia did not affect weight outcomes. Post-operatively, PPI usage increased significantly (15.8 vs 19.8%, p = 0.01) and correlated with higher dysphagia scores. CONCLUSION: A statistically validated dysphagia-specific questionnaire was utilized to evaluate the impact of LSG on dysphagia including its functional and emotional influences. The psychosocial handicap of dysphagia significantly reduced weight loss outcomes. A correlation between PPI use and dysphagia after LSG was found. The prevalence of dysphagia after LSG and the factors that contribute to its symptoms need to be further studied.
Entities:
Keywords:
Bariatric surgery; Dysphagia; Dysphagia handicap index; Quality of life (QoL); Sleeve gastrectomy
Authors: T H Taft; M Riehl; J B Sodikoff; P J Kahrilas; L Keefer; B Doerfler; J E Pandolfino Journal: Neurogastroenterol Motil Date: 2016-07-05 Impact factor: 3.598
Authors: Judith McElhiney; Matthew R Lohse; Amindra S Arora; Joanna M Peloquin; Debra M Geno; Melissa M Kuntz; Felicity B Enders; Mary Fredericksen; Adil A Abdalla; Yulia Khan; Nicholas J Talley; Nancy N Diehl; Timothy J Beebe; Ann M Harris; Gianrico Farrugia; Darlene E Graner; Joseph A Murray; G Richard Locke; Rayna M Grothe; Michael D Crowell; Dawn L Francis; April M B Grudell; Tushar Dabade; Angelica Ramirez; MhdMaan Alkhatib; Jeffrey A Alexander; Jessica Kimber; Ganapathy Prasad; Alan R Zinsmeister; Yvonne Romero Journal: Dysphagia Date: 2009-10-24 Impact factor: 3.438