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18-03-2024 | Gastroesophageal Reflux Disease

Effect of anti-reflux suture on gastroesophageal reflux symptoms after one anastomosis gastric bypass: a randomized controlled trial

Authors: Mohammad Kermansaravi, Masoumeh Shahsavan, Reza Ebrahimi, Ali Mousavimaleki, Barmak Gholizadeh, Rohollah Valizadeh, Shahab ShahabiShahmiri, Miguel A. Carbajo

Published in: Surgical Endoscopy | Issue 5/2024

Abstract

Purpose

Gastroesophageal reflux disease (GERD) is an issue after one anastomosis gastric bypass (OAGB) and modification of OAGB with adding an anti-reflux system may decrease the incidence of postoperative GERD. This study aimed to compare the efficacy of the anti-reflux mechanism to treat preoperative GERD and prevent de novo GERD.

Methods

A prospective randomized clinical trial study was conducted on patients with a body mass index of 40 and more from August 2020 to February 2022. Patients undergoing one anastomosis gastric bypass with and without anti-reflux sutures (groups A and B, respectively). These patients had follow-ups for one year after the surgery. GERD symptoms were assessed in all the patients using the GERD symptom questionnaire.

Results

The mean age was 39.5 ± 9.8 years and 40.7 ± 10.2 years in groups A and B respectively. GERD symptoms remission occurred in 76.5% and 68.4% of patients in groups A and B, respectively. The incidence of de novo GERD symptoms was lower in group A, compared to group B (6.2% and 16.1% in groups A and B respectively), without any statistically significant difference (p-value: 0.239).

Conclusion

GERD symptoms and de novo GERD after OAGB seems to be under-reported after OAGB. This study suggests that applying an anti-reflux suture can decrease de novo GERD symptoms.

Graphical abstract

Nam SY, Choi IJ, Ryu KH, Park BJ, Kim HB, Nam BH (2010) Abdominal visceral adipose tissue volume is associated with increased risk of erosive esophagitis in men and women. Gastroenterology 139(6):1902–11.e2PubMedCrossRef

Kindel TL, Oleynikov D (2016) The improvement of gastroesophageal reflux disease and barrett’s after bariatric surgery. Obes Surg 26(4):718–720PubMedCrossRef

Chiappetta S, Lainas P, Kassir R, Valizadeh R, Bosco A, Kermansaravi M (2022) Gastroesophageal reflux disease as an indication of revisional bariatric surgery-indication and results-a systematic review and metanalysis. Obes Surg 32(9):3156–3171PubMedCrossRef

De Luca M, Piatto G, Merola G, Himpens J, Chevallier JM, Carbajo MA et al (2021) IFSO update position statement on one anastomosis gastric bypass (OAGB). Obes Surg 31(7):3251–3278PubMedCrossRef

Rutledge R (2001) The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg 11(3):276–280PubMedCrossRef

Mahawar KK, Jennings N, Brown J, Gupta A, Balupuri S, Small PK (2013) “Mini” gastric bypass: systematic review of a controversial procedure. Obes Surg 23(11):1890–1898PubMedCrossRef

Carbajo M, García-Caballero M, Toledano M, Osorio D, García-Lanza C, Carmona JA (2005) One-anastomosis gastric bypass by laparoscopy: results of the first 209 patients. Obes Surg 15(3):398–404PubMedCrossRef

Carbajo MA, Luque-de-León E, Jiménez JM, Ortiz-de-Solórzano J, Pérez-Miranda M, Castro-Alija MJ (2017) Laparoscopic one-anastomosis gastric bypass: technique, results, and long-term follow-up in 1200 patients. Obes Surg 27(5):1153–1167PubMedCrossRef

Seetharamaiah S, Tantia O, Goyal G, Chaudhuri T, Khanna S, Singh JP et al (2017) LSG vs OAGB-1 year follow-up data-a randomized control trial. Obes Surg 27(4):948–954PubMedCrossRef

10.

Singh B, Saikaustubh Y, Singla V, Kumar A, Ahuja V, Gupta Y et al (2023) One anastomosis gastric bypass (OAGB) vs roux en y gastric bypass (RYGB) for remission of T2DM in patients with morbid obesity: a randomized controlled trial. Obes surg 33(4):1218–1227PubMedCrossRef

11.

Kermansaravi M, Shahmiri SS, Davarpanah Jazi AH, Valizadeh R, Weiner RA, Chiappetta S (2021) Reversal to normal anatomy after one-anastomosis/mini gastric bypass, indications and results: a systematic review and meta-analysis. Surg.Obes Relat Dis 17(8):1489–1496PubMedCrossRef

12.

Mahawar KK, Himpens J, Shikora SA, Chevallier JM, Lakdawala M, De Luca M et al (2018) The first consensus statement on one anastomosis/mini gastric bypass (OAGB/MGB) using a modified delphi approach. Obes Surg 28(2):303–312PubMedCrossRef

13.

Gyawali CP, Kahrilas PJ, Savarino E, Zerbib F, Mion F, Smout A et al (2018) Modern diagnosis of GERD: the lyon consensus. Gut 67(7):1351–1362PubMedCrossRef

14.

Schulz KF, Altman DG, Moher D (2011) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Int J Surg 9(8):672–677PubMedCrossRef

15.

Kermansaravi M, Mahawar KK, Davarpanah Jazi AH, Eghbali F, Kabir A, Pazouki A (2020) Revisional surgery after one anastomosis/mini gastric bypass: a narrative review. J Res Med Sci 25:62PubMedPubMedCentralCrossRef

16.

Franzén T, Tibbling L (2014) Is the severity of gastroesophageal reflux dependent on hiatus hernia size? World J Gastroenterol 20(6):1582–1584PubMedPubMedCentralCrossRef

17.

Jones R, Junghard O, Dent J, Vakil N, Halling K, Wernersson B et al (2009) Development of the gerdq, a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care. Aliment Pharmacol Ther 30(10):1030–1038PubMedCrossRef

18.

Kermansaravi M, Kabir A, Mousavimaleki A, Pazouki A (2020) Association between hiatal hernia and gastroesophageal reflux symptoms after one-anastomosis/mini gastric bypass. Surg Obes Relat Dis 16(7):863–867PubMedCrossRef

19.

Kermansaravi M, Shahmiri SS, Khalaj A, Jalali SM, Amini M, Alamdari NM et al (2022) The first web-based iranian national obesity and metabolic surgery database (INOSD). Obes Surg 32(6):2083–2086PubMedCrossRef

20.

Suzuki H, Matsuzaki J, Okada S, Hirata K, Fukuhara S, Hibi T (2013) Validation of the gerdq questionnaire for the management of gastro-oesophageal reflux disease in Japan. United Euro Gastroenterol J 1(3):175–183CrossRef

21.

Chiappetta S, Stier C, Ghanem OM, Dayyeh BKA, Boškoski I, Prager G et al (2023) Perioperative interventions to prevent gastroesophageal reflux disease and marginal ulcers after bariatric surgery - an international experts’ survey. Obes Surg 33(5):1449–1462PubMedCrossRef

22.

Greenberg JA, Palacardo F, Edelmuth RCL, Egan CE, Lee YJ, Schnoll-Sussman FH et al (2023) Comparative outcomes of anti-reflux surgery in obese patients with gastroesophageal reflux disease(1). J Gastrointest Surg 27(3):502–510PubMedCrossRef

23.

Chahal-Kummen M, Våge V, Kristinsson JA, Mala T (2023) Chronic abdominal pain and quality of life after roux-en-y gastric bypass and sleeve gastrectomy - a cross-cohort analysis of two prospective longitudinal observational studies. Surg Obes Relat Dis 19(8):819–829PubMedCrossRef

24.

Peterli R, Wölnerhanssen BK, Peters T, Vetter D, Kröll D, Borbély Y et al (2018) Effect of laparoscopic sleeve gastrectomy vs laparoscopic roux-en-y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. JAMA 319(3):255–265PubMedPubMedCentralCrossRef

25.

DuPree CE, Blair K, Steele SR, Martin MJ (2014) Laparoscopic sleeve gastrectomy in patients with preexisting gastroesophageal reflux disease : a national analysis. JAMA Surg 149(4):328–334PubMedCrossRef

26.

Patel P, Hobbs P, Rogers BD, Bennett M, Eckhouse SR, Eagon JC et al (2022) Reflux symptoms increase following sleeve gastrectomy despite triage of symptomatic patients to roux-en-y gastric bypass. J clin gastroenterol 58(1):24–30CrossRef

27.

Kermansaravi M, Parmar C, Chiappetta S, Shahabi S, Abbass A, Abbas SI et al (2022) Patient selection in one anastomosis/mini gastric bypass-an expert modified delphi consensus. Obes Surg 32(8):2512–2524PubMedCrossRef

28.

Slagter N, Hopman J, Altenburg AG, de Heide LJM, Jutte EH, Kaijser MA et al (2021) Applying an anti-reflux suture in the one anastomosis gastric bypass to prevent biliary reflux: a long-term observational study. Obes Surg 31(5):2144–2152PubMedCrossRef

29.

De Luca M, Tie T, Ooi G, Higa K, Himpens J, Carbajo MA et al (2018) Mini gastric bypass-one anastomosis gastric bypass (MGB-OAGB)-IFSO position statement. Obes Surg 28(5):1188–1206PubMedCrossRef

30.

Bruzzi M, Chevallier JM, Czernichow S (2017) One-anastomosis gastric bypass: why biliary reflux remains controversial? Obes Surg 27(2):545–547PubMedCrossRef

31.

Saarinen T, Pietiläinen KH, Loimaala A, Ihalainen T, Sammalkorpi H, Penttilä A et al (2020) Bile reflux is a common finding in the gastric pouch after one anastomosis gastric bypass. Obes Surg 30(3):875–881PubMedCrossRef

32.

Apers J, Wijkmans R, Totte E, Emous M (2018) Implementation of mini gastric bypass in the netherlands: early and midterm results from a high-volume unit. Surg Endosc 32(9):3949–3955PubMedCrossRef

33.

Carandina S, Soprani A, Zulian V, Cady J (2021) Long-term results of one anastomosis gastric bypass: a single center experience with a minimum follow-up of 10 years. Obes Surg 31(8):3468–3475PubMedCrossRef

34.

Musella M, Susa A, Greco F, De Luca M, Manno E, Di Stefano C et al (2014) The laparoscopic mini-gastric bypass: the italian experience: outcomes from 974 consecutive cases in a multicenter review. Surg Endosc 28(1):156–163PubMedCrossRef

35.

Nehmeh WA, Baratte C, Rives-Lange C, Martineau C, Boullenois H, Krivan S et al (2021) Acid reflux is common in patients with gastroesophageal reflux disease after one-anastomosis gastric bypass. Obes Surg 31(11):4717–4723PubMedCrossRef

36.

Felsenreich DM, Zach ML, Vock N, Jedamzik J, Eichelter J, Mairinger M et al (2023) Esophageal function and non-acid reflux evaluated by impedance-24 h-pH-metry, high-resolution manometry, and gastroscopy after one-anastomosis gastric bypass-outcomes of a prospective mid-term study. Surg endosc 37(5):3832–3841PubMedPubMedCentralCrossRef

37.

Musella M, Vitiello A, Berardi G, Velotti N, Pesce M, Sarnelli G (2021) Evaluation of reflux following sleeve gastrectomy and one anastomosis gastric bypass: 1-year results from a randomized open-label controlled trial. Surg Endosc 35(12):6777–6785PubMedCrossRef

38.

Doulami G, Triantafyllou S, Albanopoulos K, Natoudi M, Zografos G, Theodorou D (2018) Acid and nonacid gastroesophageal reflux after single anastomosis gastric bypass an objective assessment using 24-hour multichannel intraluminal impedance-pH metry. Surg Obes Relat Dis 14(4):484–488PubMedCrossRef

39.

Eskandaros MS, Abbass A, Zaid MH, Darwish AA (2021) Laparoscopic one anastomosis gastric bypass versus laparoscopic roux-en-y gastric bypass effects on pre-existing mild-to-moderate gastroesophageal reflux disease in patients with obesity: a randomized controlled study. Obes Surg 31(11):4673–4681PubMedCrossRef

40.

Borbély Y, Kröll D, Nett PC, Moreno P, Tutuian R, Lenglinger J (2018) Radiologic, endoscopic, and functional patterns in patients with symptomatic gastroesophageal reflux disease after roux-en-y gastric bypass. Surg obes relat dis 14(6):764–768PubMedCrossRef

41.

Kermansaravi M, DavarpanahJazi AH, ShahabiShahmiri S, Carbajo M, Vitiello A, Parmar CD et al (2021) Areas of non-consensus around one anastomosis/mini gastric bypass (OAGB/MGB): a narrative review. Obes Surg 31(6):2453–2463PubMedCrossRef

Title: Effect of anti-reflux suture on gastroesophageal reflux symptoms after one anastomosis gastric bypass: a randomized controlled trial
Authors: Mohammad Kermansaravi
Masoumeh Shahsavan
Reza Ebrahimi
Ali Mousavimaleki
Barmak Gholizadeh
Rohollah Valizadeh
Shahab ShahabiShahmiri
Miguel A. Carbajo
Publication date: 18-03-2024
Publisher: Springer US
Keywords: Gastroesophageal Reflux Disease
Bariatric Surgery
Bariatric Surgery
Published in: Surgical Endoscopy / Issue 5/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-024-10792-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effect of anti-reflux suture on gastroesophageal reflux symptoms after one anastomosis gastric bypass: a randomized controlled trial

Abstract

Purpose

Methods

Results

Conclusion

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Graphical abstract

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