Mohammad Kermansaravi1, Ali Kabir2, Ali Mousavimaleki3, Abdolreza Pazouki4. 1. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran; Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran. Electronic address: kermansaravi.m@iums.ac.ir. 2. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran. Electronic address: kabir.a@iums.ac.ir. 3. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran. 4. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran; Center of Excellence of European Branch of International Federation for Surgery of Obesity, Hazrat_e Rasool Hospital, Tehran, Iran.
Abstract
BACKGROUND: One-anastomosis gastric bypass (OAGB) is an accepted bariatric and metabolic surgery with certain important complications, such as postoperative gastroesophageal reflux disease (GERD) and bile reflux (BR), which are not well addressed in literature. OBJECTIVES: The present study was conducted to determine the true incidence of postoperative de novo GERD and BR and their associations with a hiatal hernia (HH). SETTING: The present research setting comprised the Center of Excellence of the European Branch of the International Federation for the Surgery of Obesity and Metabolic Disorders, Hazrat-e-Rasoul Hospital, Tehran, Iran. METHODS: The present cohort study recruited 200 patients with morbid obesity undergoing OAGB/minigastric bypass from December 2016 to February 2018 without any preoperative GERD symptoms. These patients were followed up for 1 year after the surgery. The incidence of post-OAGB GERD and BR was determined in all the patients using the GERD symptom questionnaire, GerdQ. RESULTS: The mean age of the patients was 41.0 ± 11.6 years. A hernia was observed in 56 (29.2%) cases and GERD in 37 (19.3%). Hernia was small in 44 (22.9%) cases, medium in 11 (5.7%), and large in 1 (.5%). HH was found to be significantly correlated with GERD (P = .012). CONCLUSION: The important post-OAGB complications, such as GERD and BR, have not been adequately addressed in literature. The present study found moderate and large HHs to be important factors for de novo GERD and repairing a HH during OAGB may be essential for preventing GERD-like symptoms.
BACKGROUND: One-anastomosis gastric bypass (OAGB) is an accepted bariatric and metabolic surgery with certain important complications, such as postoperative gastroesophageal reflux disease (GERD) and bile reflux (BR), which are not well addressed in literature. OBJECTIVES: The present study was conducted to determine the true incidence of postoperative de novo GERD and BR and their associations with a hiatal hernia (HH). SETTING: The present research setting comprised the Center of Excellence of the European Branch of the International Federation for the Surgery of Obesity and Metabolic Disorders, Hazrat-e-Rasoul Hospital, Tehran, Iran. METHODS: The present cohort study recruited 200 patients with morbid obesity undergoing OAGB/minigastric bypass from December 2016 to February 2018 without any preoperative GERD symptoms. These patients were followed up for 1 year after the surgery. The incidence of post-OAGB GERD and BR was determined in all the patients using the GERD symptom questionnaire, GerdQ. RESULTS: The mean age of the patients was 41.0 ± 11.6 years. A hernia was observed in 56 (29.2%) cases and GERD in 37 (19.3%). Hernia was small in 44 (22.9%) cases, medium in 11 (5.7%), and large in 1 (.5%). HH was found to be significantly correlated with GERD (P = .012). CONCLUSION: The important post-OAGB complications, such as GERD and BR, have not been adequately addressed in literature. The present study found moderate and large HHs to be important factors for de novo GERD and repairing a HH during OAGB may be essential for preventing GERD-like symptoms.
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