Lionel Sebastianelli1,2, Marine Benois1,2, Geoffroy Vanbiervliet1,2, Laurent Bailly1,3, Maud Robert4, Nicolas Turrin5, Emmanuel Gizard5, Mirto Foletto6, Marco Bisello6, Alice Albanese6, Antonella Santonicola7, Paola Iovino7, Thierry Piche1,2, Luigi Angrisani8, Laurent Turchi9, Luigi Schiavo10, Antonio Iannelli11,12,13. 1. Université Côte d'Azur, Nice, France. 2. Centre Hospitalier Universitaire de Nice, Digestive Surgery and Liver Transplantation Unit, Archet 2 Hospital, Nice, France. 3. Centre Hospitalier Universitaire de Nice, Département de Santé Publique, Nice, France. 4. Department of Digestive Surgery, Center of Bariatric Surgery, Hospital Edouard Herriot, Hospices Civils de Lyon, Lyon, France. 5. Department of Digestive Surgery, Center of Bariatric Surgery, Hospital Saint-Joseph, Marseille, France. 6. Week Surgery, Bariatric Unit, Padova University Hospital, Padova, Italy. 7. Gastrointestinal Unit, Department of Medicine and Surgery, University of Salerno, 84081, Salerno, Italy. 8. General and Endoscopic Surgery Unit, San Giovanni Bosco Hospital, Naples, Italy. 9. Inserm U1091-CNRS UMR7277-Institut de Biologie Valrose-Université Nice Sophia Antipolis, Nice, France. 10. IX Division of General Surgery, Vascular Surgery, and Applied Biotechnology, Naples University Polyclinic of Campania "Luigi Vanvitelli", Naples, Italy. 11. Université Côte d'Azur, Nice, France. iannelli.a@chu-nice.fr. 12. Centre Hospitalier Universitaire de Nice, Digestive Surgery and Liver Transplantation Unit, Archet 2 Hospital, Nice, France. iannelli.a@chu-nice.fr. 13. Inserm, U1065, Team 8 "Hepatic Complications of Obesity", Nice, France. iannelli.a@chu-nice.fr.
Abstract
BACKGROUND: Recent evidence has indicated an increased risk of Barrett's esophagus (BE) in the long term after sleeve gastrectomy (SG). AIM: The aim of the study is to investigate the spectrum of gastroesophageal reflux disease (GERD) symptoms as well as the prevalence of BE, at minimum 5 years after SG in patients who underwent SG in different bariatric centers of two countries: France and Italy. PATIENTS AND METHODS: Five high volume outpatient centers dedicated to bariatric surgery that routinely perform upper GI endoscopy before any bariatric procedures were invited to participate in the study. From January 2017 to June 2018, each center during scheduled postoperative evaluation after surgery asked a minimum 10 consecutive patients, which had performed SG at least 5 years before and with no evidence of BE preoperatively, to undergo another upper GI endoscopy. RESULTS: Ninety (66 F) consecutive patients were enrolled. The mean follow-up was 78 ± 15 months, and the mean total body weight loss was 25 ± 12%. The prevalence of BE was 18.8% with no significant difference among centers. Weight loss failure was significantly associated with BE (p < 0.01). The prevalence of GERD symptoms, erosive esophagitis, and the usage of PPIs increased from 22%, 10%, and 22% before the SG to 76%, 41%, and 52% at the time of follow-up, respectively (p < 0.05). CONCLUSIONS: This multicenter study show a high rate of BE at least 5 years after SG. Weight loss failure was significantly associated with BE. We suggest to provide systematic endoscopy in these patients to rule out this condition.
BACKGROUND: Recent evidence has indicated an increased risk of Barrett's esophagus (BE) in the long term after sleeve gastrectomy (SG). AIM: The aim of the study is to investigate the spectrum of gastroesophageal reflux disease (GERD) symptoms as well as the prevalence of BE, at minimum 5 years after SG in patients who underwent SG in different bariatric centers of two countries: France and Italy. PATIENTS AND METHODS: Five high volume outpatient centers dedicated to bariatric surgery that routinely perform upper GI endoscopy before any bariatric procedures were invited to participate in the study. From January 2017 to June 2018, each center during scheduled postoperative evaluation after surgery asked a minimum 10 consecutive patients, which had performed SG at least 5 years before and with no evidence of BE preoperatively, to undergo another upper GI endoscopy. RESULTS: Ninety (66 F) consecutive patients were enrolled. The mean follow-up was 78 ± 15 months, and the mean total body weight loss was 25 ± 12%. The prevalence of BE was 18.8% with no significant difference among centers. Weight loss failure was significantly associated with BE (p < 0.01). The prevalence of GERD symptoms, erosive esophagitis, and the usage of PPIs increased from 22%, 10%, and 22% before the SG to 76%, 41%, and 52% at the time of follow-up, respectively (p < 0.05). CONCLUSIONS: This multicenter study show a high rate of BE at least 5 years after SG. Weight loss failure was significantly associated with BE. We suggest to provide systematic endoscopy in these patients to rule out this condition.
Authors: Conor Brosnan; Jarlath C Bolger; Eamonn M Bolger; Michael E Kelly; Roisin Tully; Mohamed AlAzzawi; William B Robb Journal: Obes Surg Date: 2020-08-21 Impact factor: 4.129