Evidence map›Paper›PMID 38867101›Full record

ArticleObesity surgery2024

Prognosis of Reflux Symptom Resolution After Bariatric Surgery: How Can Preoperative Esophageal Testing Help?

Rachel Sillcox, Mary K Bryant, Saurabh Khandelwal, Benjamin M Vierra, Roger Tatum, Robert B Yates, Judy Y Chen

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Article in Obesity surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Rachel SillcoxDepartment of Surgery, University of Washington, 1959 NE Pacific St, Box 3564101, Seattle, WA, 98195, USA. rachel.sillcox@gmail.com.
Mary K BryantDepartment of Surgery, University of Washington, 1959 NE Pacific St, Box 3564101, Seattle, WA, 98195, USA.ORCID 0000-0002-2090-1653
Saurabh KhandelwalDepartment of Surgery, University of Washington, 1959 NE Pacific St, Box 3564101, Seattle, WA, 98195, USA.
Benjamin M VierraDepartment of Surgery, University of Washington, 1959 NE Pacific St, Box 3564101, Seattle, WA, 98195, USA.
Roger TatumDepartment of Surgery, University of Washington, 1959 NE Pacific St, Box 3564101, Seattle, WA, 98195, USA.
Robert B YatesDepartment of Surgery, University of Washington, 1959 NE Pacific St, Box 3564101, Seattle, WA, 98195, USA.
Judy Y ChenDepartment of Surgery, University of Washington, 1959 NE Pacific St, Box 3564101, Seattle, WA, 98195, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe incidence of unresolved postoperative reflux after bariatric surgery varies considerably. Consistent perioperative patient characteristics predictive of unresolved reflux remain unknown. We leverage our institution's comprehensive preoperative esophageal testing to identify predictors of postoperative reflux. MATERIALS AND

methodsWe performed a single-center retrospective review of adult patients with preoperative reflux symptoms who underwent either vertical sleeve gastrectomy (VSG) or Roux-en-Y gastric bypass (RYGB) from 2015 to 2021. All patients had pH and high-resolution manometry preoperatively. Predictors of postoperative unresolved reflux at 1 year were explored via Fisher's exact test, Kruskal Wallis test, and univariate logistic regression.

resultsUnresolved reflux was higher in patients undergoing VSG (n = 60/129,46.5%) vs. RYGB (n = 19/98, 19.4%). Median DeMeester scores were higher (22 vs. 13, p = .07) along with rates of ineffective esophageal motility (IEM) (31.6 vs. 8.9%, p = .01) in the 19 (19.3%) patients with unresolved postoperative reflux after RYGB compared to the resolved RYGB reflux cohort. Sixty (46.5%) of VSG patients had unresolved postoperative reflux. The VSG unresolved reflux cohort had similar median DeMeester and IEM incidence to the resolved VSG group but more preoperative dysphagia (13.3% vs. 2.9%, p = .04) and higher preoperative PPI use (56.7 vs. 39.1%, p = .05). In univariate analysis, only IEM was predictive of unresolved reflux after RYGB (OR 4.74, 95% CI 1.37, 16.4).

conclusionUnresolved reflux was higher after VSG. Preoperative IEM predicted unresolved reflux symptoms after RYGB. In VSG patients, preoperative dysphagia symptoms and PPI use predicted unresolved reflux though lack of correlation to objective testing highlights the subjective nature of symptoms and the challenges in predicting postoperative symptomatology.

Indexed as

Gastroesophageal RefluxManometryObesity, MorbidPostoperative ComplicationsPreoperative CareAdultBariatric SurgeryEsophageal pH MonitoringFemaleGastrectomyGastric BypassHumansMaleMiddle AgedPrognosisRetrospective StudiesGastric bypassGastroesophageal reflux diseaseManometrypH testingReflux symptomsSleeve gastrectomy

Identifiers

PMID38867101

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.