Improvement in gastroesophageal reflux disease symptoms after various bariatric procedures: Review of the Bariatric Outcomes Longitudinal Database |
| |
| Affiliation: | 1. Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska;2. Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska;3. Department of Surgery, Creighton University Medical Center, Omaha, Nebraska;1. Bariatric Center of Excellence, Department of Surgery, Texas Tech University Health Science Center, Lubbock, Texas;2. Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Warsaw, Poland;3. Bariatric and Reflux Center, Georgia SurgiCare, Atlanta, Georgia;4. Medical College of Georgia, Augusta, Georgia;1. Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;2. Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland;3. William S. Middleton VA Hospital, Madison, Wisconsin;1. Clinical and Experimental Medicine Department, Federico II University of Naples, Naples, Italy;2. General and Endoscopic Surgery Unit, San Giovanni Bosco Hospital, Naples, Italy;3. Medicine and Surgery Department, University of Salerno, Salerno, Italy;1. Bariatric Surgery Unit – Department of Experimental Medicine and Surgery, Tor Vergata University, Rome, Italy;2. Bariatric and Metabolic Surgery Unit – Azienda Ospedaliera-Universitaria Pisana, Pisa, Italy;3. VII Department of Surgery – La Sapienza University, Rome, Italy;4. Department of General Surgery – S. Giovanni Bosco Hospital, Naples, Italy;1. Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, California;2. South Bay Medical Center, Department of Endocrinology, Southern California Permanente Medical Group, Harbor City, California;3. Population Care Management, Southern California Permanente Medical Group, Pasadena, California;4. West Los Angeles Medical Center, Department of Surgery, Southern California Permanente Medical Group, Los Angeles, California;5. Quality Improvement, Southern California Permanente Medical Group, Pasadena, California |
| |
| Abstract: | BackgroundThe prevalence of gastroesophageal reflux disease (GERD) in the morbidly obese population is as high as 45%. The objective of this study was to compare the efficacy of various bariatric procedures in the improvement of GERD.MethodsThe Bariatric Outcomes Longitudinal Database is a prospective database of patients who undergo bariatric surgery by a participant in the American Society of Metabolic and Bariatric Surgery Center of Excellence program. GERD is graded on a 6-point scale, from 0 (no history of GERD) to 5 (prior surgery for GERD). Patients with GERD severe enough to require medications (grades 2, 3, and 4) from June 2007 to December 2009 are identified; the resolution of GERD is noted based on 6-month follow-up.ResultsOf a total of 116,136 patients, 36,938 patients had evidence of GERD preoperatively. After excluding patients undergoing concomitant hiatal hernia repair or fundoplication, there were 22,870 patients with 6-month follow-up. Mean age was 47.6±11.1 years, with an 82% female population. Mean BMI was 46.3±8.0 kg/m2. Mean preoperative GERD score for patients with Roux-en-Y gastric bypass (RYGB) was 2.80±.56, and mean postoperative score was 1.33±1.41 (P<.0001). Similarly, adjustable gastric banding (AGB, 2.77±.57 to 1.63±1.37, P<.0001) and sleeve gastrectomy (SG, 2.82±.57 to 1.85±1.40, P<.0001) had significant improvement in GERD score. GERD score improvement was best in RYGB patients (56.5%; 7955 of 14,078) followed by AGB (46%; 3773 of 8207) and SG patients (41%; 240 of 585).ConclusionAll common bariatric procedures improve GERD. Roux-en-Y gastric bypass is superior to adjustable gastric banding and sleeve gastrectomy in improving GERD. Also, the greater the loss in excess weight, the greater the improvement in GERD score. |
| |
| Keywords: | Gastroesophageal reflux disease (GERD) Bariatric Outcomes Longitudinal Database (BOLD) Roux-en-Y gastric bypass Adjustable gastric banding Sleeve gastrectomy |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
