Mazahreh Tagleb S, Aleshawi Abdelwahab J, Al-Zoubi Nabil A, Allouh Mohammed Z, Jadallah Khaled A, Elayyan Rasheed, Novotny Nathan M
Department of General Surgery and Urology, Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan.
Department of Anatomy, Faculty of Medicine, Jordan University of Science & Technology, Irbid 22110, Jordan.
Clin Exp Gastroenterol. 2019 Jul 3;12:295-301. doi: 10.2147/CEG.S216188. eCollection 2019.
To evaluate the value of esophagogastroduodenoscopy (EGD) as a preoperative investigation in individuals without symptoms of Gastro-Esophageal Reflux Disease (GERD) who will undergo laparoscopic sleeve gastrectomy (LSG).
After Institutional Review Board approval was obtained, patients scheduled for LSG were prospectively enrolled in the study between January 2016 and March 2018. Patients with symptoms of GERD were excluded from the study. Participants were randomly allocated to two groups: individuals who underwent EGD before the surgery as a usual routine investigation (Group A), and individuals who were scheduled without preoperative EGD (Group B). Patient demographics, endoscopic findings, endoscopic biopsy results, and histopathological findings of the resected parts of the stomach after LSG were analyzed and recorded. Additionally, operative characteristics and outcomes, and follow up findings were recorded and analyzed with appropriate statistical methods.
A total of 219 individuals without symptoms of GERD underwent LSG were enrolled. Group A included 111 individuals (25 males and 86 females). Group B comprised 108 individuals (20 males and 88 females). The mean age and mean Body Mass Index (BMI) were similar in both groups. From Group A, 86 out of 111 individuals (77.5%) had no pathology identified on EGD, while 21 individuals (18.9%) were found to have areas of gastric erythema and biopsies showed active gastritis. All LSG operations were performed without any major complication. After one year, all individuals were assessed for the presence of symptomatic GERD and no significant difference was found between the two groups.
Preoperative EGD may not be mandatory for asymptomatic GERD individuals undergoing LSG as post-operative complications and early follow up for GERD symptoms are not significantly different. Further prospective studies with longer follow up are needed to evaluate the role of EGD in individuals undergoing LSG.
评估食管胃十二指肠镜检查（EGD）作为术前检查手段，对于即将接受腹腔镜袖状胃切除术（LSG）且无胃食管反流病（GERD）症状个体的价值。
在获得机构审查委员会批准后，2016年1月至2018年3月期间，将计划接受LSG的患者前瞻性纳入研究。有GERD症状的患者被排除在研究之外。参与者被随机分为两组：一组是在手术前进行EGD作为常规检查的个体（A组），另一组是未安排术前EGD的个体（B组）。分析并记录患者的人口统计学数据、内镜检查结果、内镜活检结果以及LSG术后胃切除部分的组织病理学结果。此外，记录手术特征和结果以及随访结果，并采用适当的统计方法进行分析。
共有219名无GERD症状的个体接受了LSG并被纳入研究。A组包括111名个体（25名男性和86名女性）。B组由108名个体组成（20名男性和88名女性）。两组的平均年龄和平均体重指数（BMI）相似。A组中，111名个体中有86名（77.5%）在EGD检查中未发现病理异常，而21名个体（18.9%）被发现有胃红斑区域，活检显示为活动性胃炎。所有LSG手术均未出现任何重大并发症。一年后，对所有个体进行了有症状GERD的评估，两组之间未发现显著差异。
对于接受LSG的无症状GERD个体，术前EGD可能并非必需，因为术后并发症和GERD症状的早期随访并无显著差异。需要进一步进行更长时间随访的前瞻性研究，以评估EGD在接受LSG个体中的作用。
