Influencia de la cirugía bariátrica en los parámetros de manometría, pH-metria y vaciamiento isotópico en pacientes con obesidad mórbida.
One of the co-morbidities frecuently associated with morbid obesity is gastroesophagela
reflux disease (GERD). The objective of this study has been to compare
the anti-reflux effect of vertical banded gastroplasty (VBG) and Roux-en-Y gastric
bypass (RYGB), and their effect on esophageal function.
PATIENTS AND METHOD
A prospective non-randomized study on morbidly obese patients who
underwent bariatric surgery. The patients were initially assigned alternately to two
groups, according to the surgical operation performed: VBG and RYGB.
Anthropometric parameters, symptomatology of GERD, esophageal manometry, 24-
hr esophageal pH monitoring and isotopic esophageal emptying were recorded in all
patients preoperatively, at 3 months and 1 year postoperatively.
8 patients underwent VBG and 32 patients underwent RYGB. The mean age
was 36.63 ± 7.6 years in VBG group and the 36.09 ± 7.57 years in RYGB group.
50% of the VBG patients suffered from heartburn preoperatively, was
maintained at 3 months postoperatively, decreasing to 25% after 1 year. The patients
with regurgitation was 25% preoperatively, the same at 3 months but zero at 1 year.
Dysphagia was 25% preoperatively, 87.5% at 3 months and 75% continues with
dysphagia at 1 year.
59.4% of the RYGB suffered of heartburn preoperatively, 6.3% at 3 months
and 15.6% continues with heartburn at 1 year. Regurgitation was 43.8%
preoperatively, 15.6% at 3 months and 9.4% at 1 year. Preoperatively dyspahagia
was 18.8%, incrased to 43.8% at 3 months and was present at 34.4% of patients at 1
year after the operation.
The percentage of patients with objetive reflux in 24- hour continuous
esophageal monitoring in VBG group was 75% preoperatively, 25% at 3 months and
50% continues with reflux at 1 year postoperatively. In RYGB group 56.3% of
patients was reflux preoperatively, 15.6% at 3 months, increasing to 21.9% of
patients after 1 year.
The values of manometry and isotopic emptying in both groups were within
the normal range preoperatively, at 3 months and 1 year after surgery.
The patients with GBP have a significant relief of the reflux sintoms.There
are not changes in manometric studies neither isotopic emptying in the patients with
VBG and GBP.
Document Full Text
Advisor:Ortega Serrano, Joaquin; Mora Miguel, Francisco; Martínez Valls, José Fco.
School:Universitat de València
Source Type:Master's Thesis
Date of Publication:07/29/2003