FUNDOPLICATION CONVERSION IN ROUX-EN-Y GASTRIC BYPASS FOR CONTROL OF OBESITY AND GASTROESOPHAGEAL REFLUX: SYSTEMATIC REVIEW
Obesity is related with higher incidence of gastroesophageal reflux disease. Antireflux surgery has inadequate results when associated with obesity, due to migration and/or subsequent disruption of antireflux wrap. Gastric bypass, meanwhile, provides good control of gastroesophageal reflux. To evalu...
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Published in | Arquivos brasileiros de cirurgia digestiva : ABCD Vol. 30; no. 4; pp. 279 - 282 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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Brazil
Colégio Brasileiro de Cirurgia Digestiva
01.10.2017
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Abstract | Obesity is related with higher incidence of gastroesophageal reflux disease. Antireflux surgery has inadequate results when associated with obesity, due to migration and/or subsequent disruption of antireflux wrap. Gastric bypass, meanwhile, provides good control of gastroesophageal reflux.
To evaluate the technical difficulty in performing gastric bypass in patients previously submitted to antireflux surgery, and its effectiveness in controlling gastroesophageal reflux.
Literature review was conducted between July to October 2016 in Medline database, using the following search strategy: ("Gastric bypass" OR "Roux-en-Y") AND ("Fundoplication" OR "Nissen ') AND ("Reoperation" OR "Reoperative" OR "Revisional" OR "Revision" OR "Complications").
Were initially classified 102 articles; from them at the end only six were selected by exclusion criteria. A total of 121 patients were included, 68 women. The mean preoperative body mass index was 37.17 kg/m² and age of 52.60 years. Laparoscopic Nissen fundoplication was the main prior antireflux surgery (70.58%). The most common findings on esophagogastroduodenoscopy were esophagitis (n=7) and Barrett's esophagus (n=6); the most common early complication was gastric perforation (n=7), and most common late complication was stricture of gastrojejunostomy (n=9). Laparoscopic gastric bypass was performed in 99 patients, with an average time of 331 min. Most patients had complete remission of symptoms and efficient excess weight loss.
Although technically more difficult, with higher incidence of complications, gastric bypass is a safe and effective option for controlling gastroesophageal reflux in obese patients previously submitted to antireflux surgery, with the added benefit of excess weight loss. |
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AbstractList | ABSTRACT Introduction : Obesity is related with higher incidence of gastroesophageal reflux disease. Antireflux surgery has inadequate results when associated with obesity, due to migration and/or subsequent disruption of antireflux wrap. Gastric bypass, meanwhile, provides good control of gastroesophageal reflux. Objective: To evaluate the technical difficulty in performing gastric bypass in patients previously submitted to antireflux surgery, and its effectiveness in controlling gastroesophageal reflux. Methods: Literature review was conducted between July to October 2016 in Medline database, using the following search strategy: (“Gastric bypass” OR “Roux-en-Y”) AND (“Fundoplication” OR “Nissen ‘) AND (“Reoperation” OR “Reoperative” OR “Revisional” OR “Revision” OR “Complications”). Results: Were initially classified 102 articles; from them at the end only six were selected by exclusion criteria. A total of 121 patients were included, 68 women. The mean preoperative body mass index was 37.17 kg/m² and age of 52.60 years. Laparoscopic Nissen fundoplication was the main prior antireflux surgery (70.58%). The most common findings on esophagogastroduodenoscopy were esophagitis (n=7) and Barrett’s esophagus (n=6); the most common early complication was gastric perforation (n=7), and most common late complication was stricture of gastrojejunostomy (n=9). Laparoscopic gastric bypass was performed in 99 patients, with an average time of 331 min. Most patients had complete remission of symptoms and efficient excess weight loss. Conclusion: Although technically more difficult, with higher incidence of complications, gastric bypass is a safe and effective option for controlling gastroesophageal reflux in obese patients previously submitted to antireflux surgery, with the added benefit of excess weight loss. Obesity is related with higher incidence of gastroesophageal reflux disease. Antireflux surgery has inadequate results when associated with obesity, due to migration and/or subsequent disruption of antireflux wrap. Gastric bypass, meanwhile, provides good control of gastroesophageal reflux. To evaluate the technical difficulty in performing gastric bypass in patients previously submitted to antireflux surgery, and its effectiveness in controlling gastroesophageal reflux. Literature review was conducted between July to October 2016 in Medline database, using the following search strategy: ("Gastric bypass" OR "Roux-en-Y") AND ("Fundoplication" OR "Nissen ') AND ("Reoperation" OR "Reoperative" OR "Revisional" OR "Revision" OR "Complications"). Were initially classified 102 articles; from them at the end only six were selected by exclusion criteria. A total of 121 patients were included, 68 women. The mean preoperative body mass index was 37.17 kg/m² and age of 52.60 years. Laparoscopic Nissen fundoplication was the main prior antireflux surgery (70.58%). The most common findings on esophagogastroduodenoscopy were esophagitis (n=7) and Barrett's esophagus (n=6); the most common early complication was gastric perforation (n=7), and most common late complication was stricture of gastrojejunostomy (n=9). Laparoscopic gastric bypass was performed in 99 patients, with an average time of 331 min. Most patients had complete remission of symptoms and efficient excess weight loss. Although technically more difficult, with higher incidence of complications, gastric bypass is a safe and effective option for controlling gastroesophageal reflux in obese patients previously submitted to antireflux surgery, with the added benefit of excess weight loss. ABSTRACT Introduction : Obesity is related with higher incidence of gastroesophageal reflux disease. Antireflux surgery has inadequate results when associated with obesity, due to migration and/or subsequent disruption of antireflux wrap. Gastric bypass, meanwhile, provides good control of gastroesophageal reflux. Objective: To evaluate the technical difficulty in performing gastric bypass in patients previously submitted to antireflux surgery, and its effectiveness in controlling gastroesophageal reflux. Methods: Literature review was conducted between July to October 2016 in Medline database, using the following search strategy: (“Gastric bypass” OR “Roux-en-Y”) AND (“Fundoplication” OR “Nissen ‘) AND (“Reoperation” OR “Reoperative” OR “Revisional” OR “Revision” OR “Complications”). Results: Were initially classified 102 articles; from them at the end only six were selected by exclusion criteria. A total of 121 patients were included, 68 women. The mean preoperative body mass index was 37.17 kg/m² and age of 52.60 years. Laparoscopic Nissen fundoplication was the main prior antireflux surgery (70.58%). The most common findings on esophagogastroduodenoscopy were esophagitis (n=7) and Barrett’s esophagus (n=6); the most common early complication was gastric perforation (n=7), and most common late complication was stricture of gastrojejunostomy (n=9). Laparoscopic gastric bypass was performed in 99 patients, with an average time of 331 min. Most patients had complete remission of symptoms and efficient excess weight loss. Conclusion: Although technically more difficult, with higher incidence of complications, gastric bypass is a safe and effective option for controlling gastroesophageal reflux in obese patients previously submitted to antireflux surgery, with the added benefit of excess weight loss. RESUMO Introdução: Obesidade está relacionada à maior incidência de doença do refluxo gastroesofágico. Cirurgia antirrefluxo apresenta resultados inadequados quando associada à obesidade, devido à migração e/ou ruptura posterior da válvula antirrefluxo. Bypass gástrico enquanto isso determina bom controle de refluxo gastroesofágico. Objetivo: Avaliar a dificuldade técnica na realização de bypass gástrico em pacientes previamente submetidos à cirurgia antirrefluxo, e sua eficácia no controle do refluxo gastroesofágico. Método: Revisão de literatura foi realizada entre os meses de julho a outubro de 2016, na base de dados Medline, com a seguinte estratégia de busca: (“Gastric Bypass” OR “Roux-en-Y”) AND (“Fundoplication” OR “Nissen”) AND (“Reoperation” OR “Reoperative” OR “Revisional” OR “Revision” OR “Complications”). Resultados: Foram inicialmente classificados 102 artigos selecionando-se, por critérios de exclusão, apenas seis ao final. Foram incluídos 121 pacientes, sendo 68 mulheres. A média de índice de massa corporal pré-operatório foi 37,17 kg/m² e idade de 52,60 anos. Fundoplicatura de Nissen laparoscópica foi a principal operação antirrefluxo prévia (70,58%). Os achados mais comuns na endoscopia digestiva alta foram esofagite (n=7) e esôfago de Barrett (n=6); a complicação precoce mais comum foi perfuração gástrica (n=7), e tardia, estenose de anastomose gastrojejunal (n=9). Bypass laparoscópico foi realizado em 99 pacientes, com tempo médio de 331 min. A grande maioria dos pacientes apresentou completa remissão dos sintomas e perda eficiente do excesso de peso. Conclusão: Apesar de tecnicamente mais difícil, com maior incidência de complicações, o bypass gástrico é opção segura e efetiva no controle do refluxo gastroesofágico em pacientes obesos previamente submetidos à operação antirrefluxo, com a vantagem adicional da perda do excesso de peso. |
Author | Mendes-Filho, Antônio Moreira Alhinho, Helga Cristina Almeida Wahnon Ferraz, Álvaro Antônio Bandeira Campos, Josemberg Marins Galvão-Neto, Manoel Dos Passos Ramos, Almino Cardoso Godoy, Eduardo Sávio Nascimento |
AuthorAffiliation | 3 Department of Surgery and Clinical Medicine, Federal University of Pernambuco, Recife, PE, Brazil 2 Gastro Obeso Center Clinic, São Paulo, SP 1 Post-Graduation Program in Surgery, Federal University of Pernambuco, Recife, PE |
AuthorAffiliation_xml | – name: 2 Gastro Obeso Center Clinic, São Paulo, SP – name: 1 Post-Graduation Program in Surgery, Federal University of Pernambuco, Recife, PE – name: 3 Department of Surgery and Clinical Medicine, Federal University of Pernambuco, Recife, PE, Brazil |
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Snippet | Obesity is related with higher incidence of gastroesophageal reflux disease. Antireflux surgery has inadequate results when associated with obesity, due to... ABSTRACT Introduction : Obesity is related with higher incidence of gastroesophageal reflux disease. Antireflux surgery has inadequate results when associated... |
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StartPage | 279 |
SubjectTerms | Bariatric surgery Fundoplication Gastric Bypass Gastroesophageal reflux Gastroesophageal Reflux - complications Gastroesophageal Reflux - surgery Humans Laparoscopy Obesity - complications Obesity - surgery Reoperation Review |
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Title | FUNDOPLICATION CONVERSION IN ROUX-EN-Y GASTRIC BYPASS FOR CONTROL OF OBESITY AND GASTROESOPHAGEAL REFLUX: SYSTEMATIC REVIEW |
URI | https://www.ncbi.nlm.nih.gov/pubmed/29340554 https://pubmed.ncbi.nlm.nih.gov/PMC5793148 https://doaj.org/article/da46db1c17f840d5a00811f16681fa57 |
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