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Gerd symptoms after laparoscopic Roux-en-Y gastric bypass: an emerging scenario

International Journal of Obesity volume 46, pages 1076–1078 (2022)Cite this article

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Abstract

Laparoscopic Roux-en-Y gastric bypass (RYGB) is the second most performed bariatric procedure and it is considered the procedure of choice to treat patients with severe obesity and gastroesophageal reflux disease (GERD). However, some authors described the new onset or the recurrence of GERD symptoms after RYGB, and data at follow-up were scanty. In our center, we evaluated trend in weight, GERD symptoms and obesity-related comorbidities in 45 patients undergone RYGB at least 60 months before (mean follow-up 99.9 ± 22.9 months). At RYGB 51.1% patients referred preoperative GERD symptoms; among them, 47.8% showed an intraoperative hiatal hernia (HH). At medium-term follow-up mean BMI was significantly lower compared to baseline (p < 0.001). Among patients with preoperative GERD, 69.6% had GERD resolution and 30.4% reported postoperative GERD symptoms. Furthermore, 18.2% without preoperative GERD referred postoperative GERD new onset. We confirmed that RYGB as primary intervention provides satisfactory weight loss and a high percentage of GERD symptoms resolution. However, about 24.4% of patients complained of GERD symptoms at medium-term follow-up. The pathophysiology of GERD after RYGB, de novo or persistence, is not completely understood and several hypotheses could be drawn; however, further studies focusing the pathophysiology of these symptoms are needed.

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Author notes

  1. These authors contributed equally: Antonella Santonicola, Luigi Ruggiero.

Authors and Affiliations

  1. University of Salerno, Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Baronissi, SA, Italy

    Antonella Santonicola, Luigi Ruggiero & Paola Iovino

  2. Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy

    Rossella Palma

  3. Department of Public Health, “Federico II” University of Naples, Naples, Italy

    Luigi Angrisani

Authors
  1. Antonella Santonicola
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  2. Luigi Ruggiero
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  3. Rossella Palma
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  4. Luigi Angrisani
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  5. Paola Iovino
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Contributions

AS study concept and design; analysis, interpretation and acquisition of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content; statistical analysis; literature research. LR study concept and design; analysis, interpretation and acquisition of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content; statistical analysis; literature research. RP acquisition of data; critical revision of the manuscript for important intellectual content; literature research. LA study concept and design; critical revision of the manuscript for important intellectual content; literature research; study supervision. PI study concept and design; analysis and interpretation of data; drafting of the manuscript; critical revision of the manuscript for important intellectual content; statistical analysis; literature research; study supervision.

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Correspondence to Paola Iovino.

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Santonicola, A., Ruggiero, L., Palma, R. et al. Gerd symptoms after laparoscopic Roux-en-Y gastric bypass: an emerging scenario. Int J Obes 46, 1076–1078 (2022). https://doi.org/10.1038/s41366-022-01072-9

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