Author
Listed:
- Przemysław Znamirowski
(Medical College, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland
Clinic of General, Oncological and Endocrinological Surgery, Provincial Hospital in Kielce, 25-736 Kielce, Poland)
- Piotr Bryk
(Medical College, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland
Clinic of General, Oncological and Endocrinological Surgery, Provincial Hospital in Kielce, 25-736 Kielce, Poland)
- Piotr Lewitowicz
(Medical College, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland)
- Dorota Kozieł
(Medical College, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland)
- Stanisław Głuszek
(Medical College, Jan Kochanowski University in Kielce, 25-369 Kielce, Poland
Clinic of General, Oncological and Endocrinological Surgery, Provincial Hospital in Kielce, 25-736 Kielce, Poland)
Abstract
Background: Surgical treatment is the most effective method of treatment for obesity; and laparoscopic sleeve gastrectomy (LSG) is the most frequently performed bariatric surgery. Objective: The aim of the study was evaluation of the frequency of occurrence and the degree of progression of changes characteristic of GERD in patients who had undergone LSG in clinical; endoscopic; and microscopic images in the obtained bioptats; and an attempt to correlate the results obtained with the effectiveness of bariatric treatment. Materials and Method: The anonymized clinical data concerning 214 patients who had undergone LSG were collected from the database. Invitations for check-up examinations were distributed, to which 37 patients responded. Two patients were excluded from the study. In 35 patients after LSG check-up clinical examination, bariatric endoscopy (BE) and bariatric microscopy (BM) were performed on bioptats collected from the site of the gastro-esophageal junction; and 3 specimens collected at 2 cm intervals from the Z-line. The study was performed according to the standard protocol. Results: In the analyzed group, clinical symptoms of GERD occurred in 12 patients (34.5%), including 10 females and 2 males. The symptom reported by all patients was retrosternal pain/burning (heartburn). In BE, foci of ectopic mucosa in the epicardial part of the esophagus were found in 16 patients (14 F and 2 M). No correlation was observed between the analyzed parameters and the occurrence of the above-mentioned changes. In BM, only in three patients were the changes described as normal esophageal mucosa; while in another three, as foci of intestinal metaplasia, Barrett’s esophagus. In this group no foci of dysplasia were found. In eight patients, the changes were described as inflammatory. In ten patients from this group, microscopic changes occurred without clinical symptoms of the disease. Conclusions: GERD is an important clinical problem in patients after LSG; therefore; the problem of occurrence or exacerbation of symptoms of the disease should be discussed with the patient during qualification for bariatric surgery. The bariatric effectiveness of LSG does not correlate with the occurrence of the symptoms of GERD after the procedure. However; the lack of clinical symptoms of the disease does not mean the lack of its occurrence. Therefore; the endoscopic check-up after LSG should be routinely performed. During the qualification for LSG screening, histopathologic examinations of the esophagus may be useful for the assessment of the microscopic symptoms of GERD in oligosymptomatic patients; and exclusion of rare pathologies of the esophagus (e.g., eosinophilic esophagitis), which may complicate post-operative course.
Suggested Citation
Przemysław Znamirowski & Piotr Bryk & Piotr Lewitowicz & Dorota Kozieł & Stanisław Głuszek, 2021.
"GERD—A Burning Problem after Sleeve Gastrectomy?,"
IJERPH, MDPI, vol. 18(20), pages 1-13, October.
Handle:
RePEc:gam:jijerp:v:18:y:2021:i:20:p:10829-:d:656882
Download full text from publisher
Corrections
All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:20:p:10829-:d:656882. See general information about how to correct material in RePEc.
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .
Please note that corrections may take a couple of weeks to filter through
the various RePEc services.