Roux-en-Y Gastric Bypass as a Treatment for Barrett’s Esophagus after Sleeve Gastrectomy

Background Laparoscopic sleeve gastrectomy (SG) is the most frequently performed bariatric procedure today. While an increasing number of long-term studies report the occurrence of Barrett’s esophagus (BE) after SG, its treatment has not been studied, yet. Objectives The aim of this study was to eva...

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Published in:	Obesity surgery Vol. 30; no. 4; pp. 1273 - 1279
Main Authors:	Felsenreich, Daniel M., Langer, Felix B., Bichler, Christoph, Eilenberg, Magdalena, Jedamzik, Julia, Kristo, Ivan, Vock, Natalie, Gensthaler, Lisa, Rabl, Charlotte, Todoroff, Alexander, Prager, Gerhard
Format:	Journal Article
Language:	English
Published:	New York Springer US 01-04-2020 Springer Nature B.V
Subjects:	Austria Barrett Esophagus - etiology Barrett Esophagus - surgery Esophagus Gastrectomy Gastric Bypass - adverse effects Gastrointestinal surgery Humans Medicine Medicine & Public Health Obesity, Morbid - surgery Original Contributions Reoperation Retrospective Studies Surgery Treatment Outcome Weight Loss Austria Barrett’s esophagus GERD Roux-en-Y gastric bypass Sleeve gastrectomy
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Summary:	Background Laparoscopic sleeve gastrectomy (SG) is the most frequently performed bariatric procedure today. While an increasing number of long-term studies report the occurrence of Barrett’s esophagus (BE) after SG, its treatment has not been studied, yet. Objectives The aim of this study was to evaluate Roux-en-Y gastric bypass (RYGB) as treatment for BE and reflux after SG. Setting University hospital setting, Austria Methods This multi-center study includes all patients ( n = 10) that were converted to RYGB due to BE after SG in Austria. The mean interval between SG and RYGB was 42.7 months. The follow-up after RYGB in this study was 33.4 months. Gastroscopy, 24 h pH-metry, and manometry were performed and patients were asked to complete the BAROS and GIQLI questionnaires. Results Weight and BMI at the time of SG was 120.8 kg and 45.1 kg/m 2 . Eight patients (80.0%) went into remission of BE after the conversion to RYGB. Two patients had RYGB combined with hiatoplasty. The mean acid exposure time in 24 h decreased from 36.8 to 3.8% and the mean DeMeester score from 110.0 to 16.3. Patients scored 5.1 on average in the BAROS after conversion from SG to RYGB which denotes a very good outcome. Conclusions RYGB is an effective therapy for patients with BE and reflux after SG. Its outcomes in the current study were BE remission in the majority of cases as well as a decrease in reflux activity. Further studies with larger cohorts are necessary to confirm these findings.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0960-8923 1708-0428
DOI:	10.1007/s11695-019-04292-7