Edoardo Savarino1, Elisa Marabotto2, Vincenzo Savarino2. 1. Gastrointestinal Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova. 2. Gastrointestinal Unit, Department of Internal Medicine and Medical Specialties, University of Genoa, Genoa, Italy.
Abstract
PURPOSE OF REVIEW: Bariatric surgery is the best therapeutic approach to patients with morbid obesity, but there is mounting evidence that it is associated with esophageal dysfunctions, including gastroesophageal reflux disease (GERD) and motor disorders. In the present review, we summarize the existing information on the complex link between bariatric surgery and esophageal disorders. RECENT FINDINGS: Although high-quality studies on these effects are lacking, because of evident methodological flaws and retrospective nature, the review of published investigations show that pure restrictive procedures, such as laparoscopic adjustable gastric banding (LAPG) and laparoscopic sleeve gastrectomy (LSG), are associated with de novo development or worsening of GERD. Moreover, LAGB is the procedure with the greatest frequency of esophageal motor disorders, including impairment of LES relaxation and ineffective esophageal peristalsis associated with esophageal dilation. LSG seems to be less associated with esophageal dysmotility, although evidence derived from studies with objective measurements of esophageal dysfunction is limited. Finally, RYGB seems to be the best procedure for improvement of GERD symptoms and preservation of esophageal function. SUMMARY: Overall, the restrictive-malabsorptive approach represented by RYGB must be preferred to pure restrictive operations in order to avoid the negative consequences of bariatric surgery on esophageal functions.
PURPOSE OF REVIEW: Bariatric surgery is the best therapeutic approach to patients with morbid obesity, but there is mounting evidence that it is associated with esophageal dysfunctions, including gastroesophageal reflux disease (GERD) and motor disorders. In the present review, we summarize the existing information on the complex link between bariatric surgery and esophageal disorders. RECENT FINDINGS: Although high-quality studies on these effects are lacking, because of evident methodological flaws and retrospective nature, the review of published investigations show that pure restrictive procedures, such as laparoscopic adjustable gastric banding (LAPG) and laparoscopic sleeve gastrectomy (LSG), are associated with de novo development or worsening of GERD. Moreover, LAGB is the procedure with the greatest frequency of esophageal motor disorders, including impairment of LES relaxation and ineffective esophageal peristalsis associated with esophageal dilation. LSG seems to be less associated with esophageal dysmotility, although evidence derived from studies with objective measurements of esophageal dysfunction is limited. Finally, RYGB seems to be the best procedure for improvement of GERD symptoms and preservation of esophageal function. SUMMARY: Overall, the restrictive-malabsorptive approach represented by RYGB must be preferred to pure restrictive operations in order to avoid the negative consequences of bariatric surgery on esophageal functions.
Authors: Matthieu Siebert; Lara Ribeiro-Parenti; Nicholas D Nguyen; Muriel Hourseau; Belinda Duchêne; Lydie Humbert; Nicolas Jonckheere; Grégory Nuel; Jean-Marc Chevallier; Henri Duboc; Dominique Rainteau; Simon Msika; Nathalie Kapel; Anne Couvelard; André Bado; Maude Le Gall Journal: Sci Rep Date: 2020-04-30 Impact factor: 4.379
Authors: Veeravich Jaruvongvanich; Reem Matar; Karthik Ravi; M Hassan Murad; Kornpong Vantanasiri; Nicha Wongjarupong; Patompong Ungprasert; Eric J Vargas; Daniel B Maselli; Larry J Prokop; Barham K Abu Dayyeh Journal: Clin Transl Gastroenterol Date: 2020-08 Impact factor: 4.396