Yormaz Serdar, Yilmaz Kafali, Alptekin Husnu, Ece Ilhan, Acar Fahrettin, Colak Bayram, Kafali Mehmet Ertugrul, Sahin Enes, Sahin Mustafa
Ann Ital Chir. 2018;89:36-44.
Performance of routine preoperative esophagogastroduodenal endoscopy (EGE) in patients undergoing bariatric surgery is still a controversial subject. The purpose of our study was to evaluate the benefits of performing preoperative EGE in a cohort of bariatric patients.
The present retrospective study was performed between March 2010 and June 2016. We divided the study participants into two groups: group A comprised subjects without disturbing upper digestive signs, while group B comprised patients with disturbing upper digestive signs. Logistic regression analysis was used to identify the predictors that might be associated with abnormal outcomes.
Our study included 232 patients (who had undergone sleeve gastrectomy, gastric bypass, ileal interposition, or transit bipartition). The average age was 41.4 ± 10.3 years, and the average body mass index (BMI) was 43.6 ± 5.1 kg/m2. Of all the observed gastroscopic abnormalities, the prevalence for gastritis (17.3%), followed by esophagitis (10.2%), hiatus hernia (9.4%), and bulbitis (8.7%). In multivariate regression analysis, the Gastrointestinal Symptom Rating Scale (GSRS) score and upper gastric symptoms were found to be the only independent predictive markers (OR = 2.822, 95% CI: 1.674-3.456 and OR =2.735, 95% CI: 1.827-3.946, respectively). We identified a positive correlation between abnormal EGE findings and postoperative complications.
Preoperative EGE had a high rate of detection for the possible abnormalities prior to bariatric surgery. Upper gastric symptoms are significant predictive factors of postoperative complications. Performing preoperative EGE for symptomatic patients could help reduce the morbidity and mortality rates in these patients.
Bariatric surgery, Preoperative endoscopy, Upper digestive symptoms.
在接受减肥手术的患者中，常规术前食管胃十二指肠内镜检查（EGE）的作用仍是一个有争议的话题。我们研究的目的是评估在一组减肥患者中进行术前EGE的益处。
本回顾性研究于2010年3月至2016年6月进行。我们将研究参与者分为两组：A组包括无明显上消化道症状的受试者，而B组包括有明显上消化道症状的患者。采用逻辑回归分析来确定可能与异常结果相关的预测因素。
我们的研究包括232例患者（接受了袖状胃切除术、胃旁路术、回肠置入术或双通道分流术）。平均年龄为41.4±10.3岁，平均体重指数（BMI）为43.6±5.1kg/m²。在所有观察到的胃镜异常中，胃炎的患病率最高（17.3%），其次是食管炎（10.2%）、食管裂孔疝（9.4%）和十二指肠球炎（8.7%）。在多变量回归分析中，发现胃肠道症状评分量表（GSRS）得分和上腹部症状是仅有的独立预测指标（OR分别为2.822，95%CI：1.674 - 3.456和OR = 2.735，95%CI：1.827 - 3.946）。我们发现EGE异常结果与术后并发症之间存在正相关。
术前EGE对减肥手术前可能存在的异常有较高的检出率。上腹部症状是术后并发症的重要预测因素。对有症状的患者进行术前EGE有助于降低这些患者的发病率和死亡率。
减肥手术；术前内镜检查；上消化道症状
