Difante Lucas Dos Santos, Trindade Eduardo Neubarth, Lopes Antonio de Barros, Martins Eduardo Ferreira, Remus Isadora Bosini, Trindade Manoel Roberto Maciel
Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Department of Digestive Surgery - Porto Alegre (RS), Brazil.
Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Department of Gastroenterology - Porto Alegre (RS), Brazil.
Arq Bras Cir Dig. 2024 Dec 2;37:e1842. doi: 10.1590/0102-6720202400048e1842. eCollection 2024.
There is recent evidence showing that obesity is associated with gastroesophageal reflux disease and esophageal dysmotility, although symptoms are not always present.
This is a prospective study based on high-resolution manometry findings in bariatric surgery candidates and their correlation with postoperative dysphagia.
Manometric evaluation was performed on candidates for bariatric surgery from 2022 to 2024. The examination was conducted according to the protocol of the fourth version of the Chicago Classification, including different positions and provocative maneuvers to confirm the diagnosis of dysmotility. Patients were followed for 90 days after surgery to verify the occurrence of dysphagia or difficulty adapting to the diet.
High-resolution manometry was performed on 46 candidates for bariatric surgery with a mean body mass index of 46.5 kg/m2. Esophagogastric junction outflow obstruction was diagnosed in 16 (34.8%) patients, and ineffective esophageal motility was diagnosed in 8 (17.4%) patients. None of the subjects reported symptoms during the preoperative period. Out of the 46 individuals initially included, 44 underwent bariatric surgery, 23 (52.3%) underwent Roux-en-Y gastric bypass, and 21 (47.7%) underwent sleeve gastrectomy. One patient with esophagogastric junction outflow obstruction reported dysphagia after Roux-en-Y bypass, but symptoms spontaneously resolved during the 90-day follow-up period.
Although patients with severe obesity have a high prevalence of esophageal motility disorders, no clinical repercussions were observed after bariatric surgery during the study period.
最近有证据表明，肥胖与胃食管反流病及食管动力障碍有关，尽管并非总是出现症状。
这是一项基于对肥胖症手术候选者进行高分辨率测压结果及其与术后吞咽困难相关性的前瞻性研究。
对2022年至2024年肥胖症手术候选者进行测压评估。检查按照芝加哥分类第四版方案进行，包括不同体位和激发动作以确诊动力障碍。术后对患者随访90天，以核实吞咽困难或饮食适应困难的发生情况。
对46例肥胖症手术候选者进行了高分辨率测压，平均体重指数为46.5kg/m²。16例（34.8%）患者被诊断为食管胃交界部流出道梗阻，8例（17.4%）患者被诊断为食管动力无效。术前所有受试者均未报告症状。最初纳入的46人中，44人接受了肥胖症手术，23例（52.3%）接受了Roux-en-Y胃旁路手术，21例（47.7%）接受了袖状胃切除术。1例食管胃交界部流出道梗阻患者在Roux-en-Y旁路手术后出现吞咽困难，但在90天随访期内症状自行缓解。
尽管重度肥胖患者食管动力障碍患病率较高，但在研究期间肥胖症手术后未观察到临床不良反应。
