General Surgery Department, Bariatric Surgery Program, Hospital Privado Universitario de Córdoba, Naciones Unidas 346, 5016, Córdoba, Argentina.
Obes Surg. 2020 Apr;30(4):1194-1199. doi: 10.1007/s11695-019-04333-1.
The association between gastroesophageal reflux disease (GERD) and obesity is clearly defined. The incidence of erosive esophagitis (EE) and Barrett's esophagus (BE) are as high as 26 and 6%, respectively. Gastric bypass (GBP) is considered the gold standard for obese patients with GERD. Evidence about the impact of GBP on EE and BE is not yet clear but more inspiring every day.
Obese patients operated by GBP with EE or BE were included for this study. Demographics, BMI, %EWL, and the evolution of EE and BE with pre and postoperative upper endoscopy were analyzed.
In this study, 64 patients were included, 55 with EE and 9 with BE. The preoperative BMI was 44.29 km/m ± 3.5 and the %EWL was 78.5 ± 5.8 in the first year postoperative. Preoperatively, EE was distributed as follows: A: 54.5% (30), B: 34.5% (19), C: 9% (5), D: 2% (1). BE findings were the following: short segment (SSBE): 45% (4) and long segment (LSBE): 55% (5). Postoperatively, 80% of the patients with EE resolved their condition, 11% improved, 7% had no changes, and 2% worsened. From the patients with SSBE, 75% resolved their condition and 40% with LSBE resolved their condition after 24 months and no patient progressed to dysplasia.
Patients with EE had a statistically significant resolution after GBP. BE was improved or even resolved in many patients without acquiring significance but also without progression. Long-term surveillance data is necessary to define the certain evolution of EE and BE after GBP.
胃食管反流病（GERD）和肥胖之间的关联已明确界定。糜烂性食管炎（EE）和巴雷特食管（BE）的发生率分别高达 26%和 6%。胃旁路手术（GBP）被认为是 GERD 肥胖患者的金标准。关于 GBP 对 EE 和 BE 的影响的证据尚不清楚，但每天都在变得更加鼓舞人心。
本研究纳入了接受 GBP 手术治疗且患有 EE 或 BE 的肥胖患者。分析了人口统计学、BMI、%EWL 以及术前和术后上消化道内镜检查中 EE 和 BE 的演变情况。
本研究共纳入 64 例患者，其中 55 例患有 EE，9 例患有 BE。术前 BMI 为 44.29±3.5kg/m²，术后第 1 年的 %EWL 为 78.5±5.8。术前 EE 分布如下：A 型：54.5%（30 例），B 型：34.5%（19 例），C 型：9%（5 例），D 型：2%（1 例）。BE 发现如下：短节段（SSBE）：45%（4 例），长节段（LSBE）：55%（5 例）。术后，80%的 EE 患者病情得到缓解，11%的患者病情改善，7%的患者病情无变化，2%的患者病情恶化。24 个月后，75%的 SSBE 患者病情缓解，40%的 LSBE 患者病情缓解，且无患者进展为异型增生。
GBP 后 EE 患者的病情有统计学意义上的缓解。许多 BE 患者的病情得到改善甚至缓解，但没有统计学意义，也没有进展。需要长期监测数据来明确 GBP 后 EE 和 BE 的具体演变情况。
