Department of Internal Medicine, MC Slotervaart, Amsterdam, the Netherlands.
Department of Internal Medicine, MC Slotervaart, Amsterdam, the Netherlands.
Surg Obes Relat Dis. 2019 Jun;15(6):871-877. doi: 10.1016/j.soard.2019.03.018. Epub 2019 Mar 20.
Roux-en-Y gastric bypass (RYGB) is an effective treatment for morbid obesity, but many patients have increased gastrointestinal symptoms.
To evaluate gastrointestinal symptoms and food intolerance before and after RYGB over time in a large cohort of morbidly obese patients.
A high-volume bariatric center of excellence.
A prospective cohort study was performed in patients who underwent RYGB between September 2014 and July 2015, with 2-year follow-up. Consecutive patients screened for bariatric surgery answered the Gastrointestinal Symptom Rating Scale (GSRS) and a food intolerance questionnaire before RYGB and 2 years after surgery. The prevalence of gastrointestinal symptoms before and after surgery and the association between patient characteristics and postoperative gastrointestinal symptoms were assessed.
Follow-up was 86.2% (n = 168) for patients undergoing primary RYGB and 93.3% (n = 28) for revisional RYGB. The total mean GSRS score increased from 1.69 to 2.31 after surgery (P < .001), as did 13 of 16 of the individual scores. Preoperative GSRS score is associated with postoperative symptom severity (B = .343, P < .001). Food intolerance was present in 16.1% of patients before primary RYGB, increasing to 69.6% after surgery (P < .001). Patients who underwent revisional RYGB had a symptom severity and prevalence of food intolerance comparable with that among patients with primary RYGB, even though they had more symptoms before revisional surgery.
Two years after surgery, patients who underwent primary RYGB have increased gastrointestinal symptoms and food intolerance compared with the preoperative state. It is important that clinicians are aware of this and inform patients before surgery.
Roux-en-Y 胃旁路术（RYGB）是治疗病态肥胖症的有效方法，但许多患者会出现胃肠道症状加重的情况。
在一个大型病态肥胖患者队列中，评估 RYGB 术后随时间推移的胃肠道症状和食物不耐受情况。
一个卓越的大容量减重中心。
对 2014 年 9 月至 2015 年 7 月期间接受 RYGB 的患者进行前瞻性队列研究，随访时间为 2 年。对接受减重手术筛查的连续患者在 RYGB 术前和术后 2 年回答胃肠道症状严重程度评分量表（GSRS）和食物不耐受问卷。评估手术前后胃肠道症状的发生率和患者特征与术后胃肠道症状之间的关系。
对行原发性 RYGB 的患者的随访率为 86.2%（n=168），对行再次 RYGB 的患者的随访率为 93.3%（n=28）。术后，总的 GSRS 评分从 1.69 增加到 2.31（P<.001），16 项中的 13 项单项评分也均升高。术前 GSRS 评分与术后症状严重程度相关（B=0.343，P<.001）。在原发性 RYGB 术前，有 16.1%的患者存在食物不耐受，术后增加至 69.6%（P<.001）。尽管再次 RYGB 的患者术前症状更严重，但他们的症状严重程度和食物不耐受发生率与原发性 RYGB 患者相当。
与术前状态相比，行原发性 RYGB 的患者在术后 2 年内胃肠道症状和食物不耐受增加。临床医生了解这一点并在手术前告知患者非常重要。
