%0 Journal Article
%T Preliminary Results of a Study Comparing Pre-sleeve Endoscopic Fundoplication to Gastric Bypass on Gastroesophageal Reflux Disease Outcomes.
%A Antonetti M
%A Norris L
%A Strickland G
%J Obes Surg
%V 33
%N 1
%D 01 2023
%M 36355318
%F 3.479
%R 10.1007/s11695-022-06352-x
%X Gastroesophageal reflux disease (GERD) is a significant complication of sleeve gastrectomy (SG). Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) is considered the primary treatment for bariatric surgery candidates with GERD. Post-operative options for GERD management are limited. This study compares the effect of transoral fundoplication (TF) prior to SG vs LRYGB in patients with GERD .
Of 30 consecutive bariatric surgery patients with GERD between 3/22/2018 and 6/23/2020, 15 patients underwent TF prior to SG (TF/SG) and 15 patients underwent LRYGB. Subjective and objective criteria, including the GERD Health-Related Quality of Life (HRQL) and Reflux Symptom Index (RSI) survey, were used to assess symptoms. Surveys were collected pre-operatively, post-TF/pre-SG, 4-6 and 12-15 months post bariatric procedure.
Preoperative mean scores were as follows: HRQL 32.53, RSI 21.7, 93% proton pump inhibitor (PPI) usage, 6.5% satisfaction rate. Mean BMI: 45.99 (TF/SG), 42.27 (LRYGB). At 12-15 months postoperatively: mean HRQL scores were 5.53 (TF/SG) and 6.67 (LRYGB). Both groups had a statistically significant improvement in HRQL-RSI postoperatively. PPI usage was 13% (TF/SG) and 34% (LRYGB). BMI decrease was 24% (TF/SG) and 31% (LRYGB).
TF/SG is at least equivalent to LRYGB in resolution or reduction of reflux symptoms at 12-15 months.