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减肥手术后10年的胃食管反流病——这是个问题吗?一项多中心研究(BARI - 10 - POL)

Gastroesophageal Reflux Disease 10 Years After Bariatric Surgery-Is It a Problem? A Multicenter Study (BARI-10-POL).

作者信息

Dowgiałło-Gornowicz Natalia, Proczko-Stepaniak Monika, Kloczkowska Anna, Jaworski Paweł, Major Piotr

机构信息

Department of General, Minimally Invasive and Elderly Surgery, Collegium Medicum, University of Warmia and Mazury, 10-045 Olsztyn, Poland.

Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, 80-214 Gdańsk, Poland.

出版信息

J Clin Med. 2025 Jul 31;14(15):5405. doi: 10.3390/jcm14155405.


DOI:10.3390/jcm14155405
PMID:40807024
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12346909/
Abstract

: Gastroesophageal reflux disease (GERD) seems to be a common complaint which persists or develops after metabolic bariatric surgery (MBS). Endoscopic evaluation is vital in both the preoperative and postoperative phases to ensure optimal patient outcomes. The aim of this study was to evaluate the prevalence of GERD after MBS in a 10-year follow-up and analyze the endoscopic outcomes. : This retrospective, multicenter study included 368 patients who underwent single bariatric procedure. The data came from five bariatric centers in Poland, part of the BARI-10-POL project. Data on symptoms of GERD, endoscopic findings, demographics, and surgical outcomes were collected for a 10-year follow-up period. Surgical procedures included SG, Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). : Of the 305 patients without symptoms of GERD, 12.3% developed de novo GERD postoperatively. There was no statistical significance regarding the new-onset symptoms and the type of MBS ( = 0.074) and the presence of symptoms of GERD and the type of MBS ( = 0.208). However, SG was associated with a significantly lower likelihood of GERD remission after MBS ( = 0.005). Endoscopic evaluation showed abnormal findings in asymptomatic patients in both preoperative (35.8%) and postoperative (14.1%) examinations ( < 0.001). : GERD may be a common issue after MBS. One-quarter of patients after MBS may experience symptoms of GERD, regardless of the type of MBS. SG appears to be associated with a higher risk of persistent symptoms of GERD and a lower likelihood of GERD remission after MBS. Asymptomatic patients both before and after MBS may have abnormal findings in gastroscopy.

摘要

胃食管反流病(GERD)似乎是代谢性减重手术后持续存在或新发的常见问题。内镜评估在术前和术后阶段对于确保患者获得最佳预后都至关重要。本研究的目的是评估代谢性减重手术10年随访后的GERD患病率,并分析内镜检查结果。:这项回顾性多中心研究纳入了368例行单一减重手术的患者。数据来自波兰的五个减重中心,是BARI - 10 - POL项目的一部分。收集了10年随访期内GERD症状、内镜检查结果、人口统计学数据和手术结果的数据。手术方式包括袖状胃切除术(SG)、Roux - en - Y胃旁路术(RYGB)和单吻合口胃旁路术(OAGB)。:在305例无GERD症状的患者中,12.3%术后新发GERD。新发症状与代谢性减重手术类型(P = 0.074)以及GERD症状的存在与代谢性减重手术类型(P = 0.208)之间无统计学意义。然而,SG与代谢性减重手术后GERD缓解的可能性显著降低相关(P = 0.005)。内镜评估显示,无症状患者术前(35.8%)和术后(14.1%)检查均有异常发现(P < 0.001)。:GERD可能是代谢性减重手术后的常见问题。无论代谢性减重手术的类型如何,四分之一的代谢性减重手术后患者可能会出现GERD症状。SG似乎与GERD持续症状的较高风险以及代谢性减重手术后GERD缓解的较低可能性相关。代谢性减重手术前后的无症状患者在胃镜检查中可能有异常发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2c0/12346909/b9d467743fe2/jcm-14-05405-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2c0/12346909/4ede73b1a548/jcm-14-05405-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2c0/12346909/b9d467743fe2/jcm-14-05405-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2c0/12346909/4ede73b1a548/jcm-14-05405-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2c0/12346909/b9d467743fe2/jcm-14-05405-g002.jpg

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本文引用的文献

[1]
Comparative Effectiveness of Bariatric Surgery Versus GLP-1 Receptor Agonists in Reducing the Risk of New-Onset of NASH: A Retrospective Multinational Cohort Study From North America and Europe.

Endocrinol Diabetes Metab. 2025-7

[2]
Bariatric surgery in Poland, 2023: growth, trends, and impact of the KOS‑BAR program.

Wideochir Inne Tech Maloinwazyjne. 2024-11-19

[3]
Long-Term Outcomes of Laparoscopic Roux-en-Y Gastric Bypass vs Laparoscopic Sleeve Gastrectomy for Obesity: The SM-BOSS Randomized Clinical Trial.

JAMA Surg. 2025-4-1

[4]
Long-term effect of Roux-en-Y gastric bypass versus sleeve gastrectomy on reflux and Barrett's oesophagus: a randomized controlled trial.

ANZ J Surg. 2025-5

[5]
American Society for Gastrointestinal Endoscopy guideline on the diagnosis and management of GERD: summary and recommendations.

Gastrointest Endosc. 2025-2

[6]
Efficacy of One-Anastomosis Gastric Bypass Versus Roux-en-Y Gastric Bypass for Gastroesophageal Reflux Disease: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Obes Surg. 2024-12

[7]
Effect of sleeve gastrectomy on distal esophagus at 5 and 10 years.

Surg Endosc. 2025-1

[8]
Use of proton pump inhibitors after laparoscopic gastric bypass and sleeve gastrectomy: a nationwide register-based cohort study.

Int J Obes (Lond). 2024-11

[9]
Conversion of Sleeve Gastrectomy to Roux-en-Y Gastric Bypass: Is Intrathoracic Migration of the Sleeve of High Incidence?

Obes Surg. 2024-8

[10]
The real occurrence of gastroesophageal reflux disease after sleeve gastrectomy - a prospective pH-monitoring study.

Wideochir Inne Tech Maloinwazyjne. 2024-6

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