OBJECTIVE: The aim of this study was to appraise the prevalence of gastroesophageal reflux disease (GERD), esophagitis, and Barrett's esophagus (BE) after sleeve gastrectomy (SG) through a systematic review and meta-analysis. BACKGROUND: The precise prevalence of new-onset or worsening GERD after SG is controversial. Subsequent esophagitis and BE can be a serious unintended sequalae. Their postoperative prevalence remains unclear. METHODS: A systematic literature search was performed to identify studies evaluating postoperative outcomes in primary SG for morbid obesity. The primary outcome was prevalence of GERD, esophagitis, and BE after SG. Meta-analysis was performed to calculate combined prevalence. RESULTS: A total of 46 studies totaling 10,718 patients were included. Meta-analysis found that the increase of postoperative GERD after sleeve (POGAS) was 19% and de novo reflux was 23%. The long-term prevalence of esophagitis was 28% and BE was 8%. Four percent of all patients required conversion to RYGB for severe reflux. CONCLUSIONS: The postoperative prevalence of GERD, esophagitis, and BE following SG is significant. Symptoms do not always correlate with the presence of pathology. As the surgical uptake of SG continues to increase, there is a need to ensure that surgical decision-making and the consent process for this procedure consider these long-term complications while also ensuring their postoperative surveillance through endoscopic and physiological approaches. The long-term outcomes of this commonly performed bariatric procedure should be considered alongside its weight loss and metabolic effects.
OBJECTIVE: The aim of this study was to appraise the prevalence of gastroesophageal reflux disease (GERD), esophagitis, and Barrett's esophagus (BE) after sleeve gastrectomy (SG) through a systematic review and meta-analysis. BACKGROUND: The precise prevalence of new-onset or worsening GERD after SG is controversial. Subsequent esophagitis and BE can be a serious unintended sequalae. Their postoperative prevalence remains unclear. METHODS: A systematic literature search was performed to identify studies evaluating postoperative outcomes in primary SG for morbid obesity. The primary outcome was prevalence of GERD, esophagitis, and BE after SG. Meta-analysis was performed to calculate combined prevalence. RESULTS: A total of 46 studies totaling 10,718 patients were included. Meta-analysis found that the increase of postoperative GERD after sleeve (POGAS) was 19% and de novo reflux was 23%. The long-term prevalence of esophagitis was 28% and BE was 8%. Four percent of all patients required conversion to RYGB for severe reflux. CONCLUSIONS: The postoperative prevalence of GERD, esophagitis, and BE following SG is significant. Symptoms do not always correlate with the presence of pathology. As the surgical uptake of SG continues to increase, there is a need to ensure that surgical decision-making and the consent process for this procedure consider these long-term complications while also ensuring their postoperative surveillance through endoscopic and physiological approaches. The long-term outcomes of this commonly performed bariatric procedure should be considered alongside its weight loss and metabolic effects.
Authors: Robert Rutledge; Mervyn Deitel; Miguel A Carbajo; Enrique Luque-de-Leon; Sonja Chiappetta; Aatif Inam; Karl Rheinwalt; Arun Prasad; David E Hargroder; Vladimir Samoylov; M Mahir Ozmen; Chetan Parmar; António Albuquerque; Gurvinder Jammu; Murat Ustun; Nasser Sakran; Recep Aktimur; Amir Khan; Yasser Hamza; Adriana Rotundo; Marc Focquet; Michael Van den Bossche; Om Tantia; Francesco Greco; Midhat Abu Sneineh; Francisco Barrera Rodriguez; Mario Musella; Miroslav Ilić; Imran Abbas Journal: Obes Surg Date: 2020-02 Impact factor: 4.129
Authors: Daniel M Felsenreich; Felix B Langer; Christoph Bichler; Magdalena Eilenberg; Julia Jedamzik; Ivan Kristo; Natalie Vock; Lisa Gensthaler; Charlotte Rabl; Alexander Todoroff; Gerhard Prager Journal: Obes Surg Date: 2020-04 Impact factor: 4.129
Authors: Nienke Slagter; Jonne Hopman; Anna G Altenburg; Loek J M de Heide; Ewoud H Jutte; Mirjam A Kaijser; Stefan L Damen; André P van Beek; Marloes Emous Journal: Obes Surg Date: 2021-01-26 Impact factor: 4.129
Authors: Janey S A Pratt; Sebastian S Roque; Ruben Valera; Kathryn S Czepiel; Deborah D Tsao; Fatima Cody Stanford Journal: Semin Pediatr Surg Date: 2020-01-20 Impact factor: 2.754