Franco J Signorini, MD1, German R Viscido, MD1, Veronica Gorodner, MD2, Lucio R Obeide1, Federico Moser1. 1Hospital Privado Universitario de Córdoba, 2Unidades Bariatricas, Buenos Aires
INTRODUCTION: The incidence of erosive esophagitis (EE) and Barret´s esophagus (BE) is as high as 26% and 6% respectively in bariatric patients. Although the benefits of Roux-en-Y gastric by pass (RYGB) regarding gastroesophageal reflux disease (GERD) have been well documented, the reports of the effects of this procedure among EE and BE are scarce. The aim of this study is to evaluate the postoperative evolution of EE and BE after RYGB.
METHODS AND PROCEDURES: A retrospective study from a prospective database was performed. Patients who had EE or BE and RYGB in our institution between 2013 and 2017 were included. Demographics, BMI and %EWL evolution were analysed. Upper endoscopy pre and post operative and their biopsies results were assesed. Post operative data was collected at 24 months after surgery. EE was classified following the Los Angeles criteria.
RESULTS: 64 patients were included, 55 had EE and 9 BE. Mean age, BMI and %EWL were 46.9 years, 44.29 kg/m2 ± 3.5 and 78.5±5.8% respectively. Patients with EE were distibuted as follows: A: 54.5% (n=30) , B: 34.5% (n=19), C: 10% (n=5) and D: 2%. 87% and 84% of patients with grade A and B resolved their condition respectively (p<0.001 for both cases). 20% of patients with grade C resolved while 80% improved to grade A. The only patient with grade D resolved his esophagitis.
Nine patients had histological diagnosis of BE preoperatively. 4 (45%) were short segment Barret´s esophagus (SSBE) and 5 (55%) were long (LSBE). 75% of SSBE (p=0.1429) and 40% of LSBE (p=0.1667) had endoscopic and histopathological resolution. One patient (25%) with SSBE and 2 patients (40%) with LSBE remained the same. 1 patient (20%) with LSBE improved to SSBE.
CONCLUSION: In our experience, RYGB promoted the improvement and even resolution of EE and BE in a significant number of patients, without observing disease progression in any case. Long term studies should be perform in order to establish EE and BE definite behaviour after RYGB.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95508
Program Number: P171
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster