Department of Surgery, Medical Academy, Lithuanian University of Health Science, 44307 Kaunas, Lithuania.
Department of Gastroenterology, Medical Academy, Lithuanian University of Health Science, 44307 Kaunas, Lithuania.
Medicina (Kaunas). 2024 Jul 28;60(8):1221. doi: 10.3390/medicina60081221.
The prevalence of GERD is increasing among individuals with obesity, and RYGB is an effective procedure to control GERD and obesity. However, some patients continue to have GERD after RYGB. The aim of this study was to investigate the prevalence and the risk factors for GERD after RYGB. : This prospective study included 180 RYGB patients followed for an average of 12.2 (0.6) years. In total, 126 (70%) patients agreed to participate and provided data on their weight, GERD symptoms, and filled the GERD-HRQL, TFEQ-18, and GSRS questionnaires. The average age before surgery was 42.7 (10.5) years, and BMI was 45.2 (6.4) kg/m. Moreover, 128 (71.1%) were females, and preoperative GERD was diagnosed in 74 (41.1%) patients. At the 12-year follow-up, the mean %EBMIL and %TWL was 60.37 and 25.73, respectively. The median %WR was 18.0 (39.0). Postoperative GERD was present in 30 (23.8%) patients, of whom 12 (40%) continued to have GERD symptoms and 18 (60%) developed de novo GERD. The GERD-HRQL score significantly decreased from 3.0 (9.0) at baseline to 2.0 (5.0) ( = 0.028) at 12 years. GSRS Diarrhea and Indigestion scores increased significantly from 1.33 (0.67) to 1.5 (2.42) ( < 0.001) and from 2.0 (1.25) to 2.25 (1.25) ( < 0.001), respectively. No change in the cognitive restraint score was observed. Uncontrolled eating and emotional eating scores decreased from 51.85 (22.22) to 40.74 (33.33) ( < 0.001) and from 44.44 (44.44) to 33.33 (22.22) ( < 0.001), respectively. In the multivariate analysis, %WR > 11 (OR = 3.22, = 0.029) and GSRS Diarrhea score (OR = 3.21, = 0.027) were significant predictors of GERD 12 years after RYGB. RYGB was an effective procedure to control GERD; however, 23.8% had persistent or de novo GERD after 12 years. The independent risk factors associated with GERD after RYGB were weight regain and GSRS Diarrhea score.
胃食管反流病（GERD）在肥胖人群中的患病率正在增加，减重手术（RYGB）是控制 GERD 和肥胖的有效方法。然而，一些患者在 RYGB 后仍持续存在 GERD。本研究旨在调查 RYGB 后 GERD 的患病率和危险因素。
这项前瞻性研究纳入了 180 例接受 RYGB 治疗的患者，平均随访 12.2（0.6）年。共有 126（70%）例患者同意参与，并提供了体重、GERD 症状以及 GERD-HRQL、TFEQ-18 和 GSRS 问卷的数据。手术前患者的平均年龄为 42.7（10.5）岁，BMI 为 45.2（6.4）kg/m。此外，128（71.1%）例为女性，74（41.1%）例术前诊断为 GERD。在 12 年的随访中，平均 EBMIL 和 TWL 分别为 60.37%和 25.73%，中位 WR 为 18.0（39.0）。术后 GERD 发生在 30（23.8%）例患者中，其中 12（40%）例持续存在 GERD 症状，18（60%）例出现新发 GERD。GERD-HRQL 评分从基线时的 3.0（9.0）显著降低至 12 年时的 2.0（5.0）（=0.028）。GSRS 腹泻和消化不良评分分别从 1.33（0.67）显著增加至 1.5（2.42）（<0.001）和 2.0（1.25）至 2.25（1.25）（<0.001）。认知约束评分无变化。未观察到失控进食和情绪进食评分的变化，分别从 51.85（22.22）降至 40.74（33.33）（<0.001）和 44.44（44.44）降至 33.33（22.22）（<0.001）。多变量分析显示，WR>11（OR=3.22，=0.029）和 GSRS 腹泻评分（OR=3.21，=0.027）是 RYGB 后 12 年 GERD 的显著预测因素。RYGB 是控制 GERD 的有效方法；然而，12 年后仍有 23.8%的患者存在持续性或新发 GERD。与 RYGB 后 GERD 相关的独立危险因素是体重反弹和 GSRS 腹泻评分。
