{Reference Type}: Journal Article
{Title}: Significant and Distinct Impacts of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass on Esophageal Acid Exposure, Esophageal Motility and Endoscopic Findings: A Systematic Review and Meta-analysis.
{Author}: Valentini DF;Mazzini GS;da Silva GL;Simões AB;Gazzi VS;Alves JBO;Campos VJ;Gurski RR;
{Journal}: J Gastrointest Surg
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jun 18
{Factor}: 3.267
{DOI}: 10.1016/j.gassur.2024.06.014
{Abstract}: <B>OBJECTIVE: </B>To study esophageal acid exposure, esophageal motility, and endoscopic findings before and after Sleeve Gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB BACKGROUND: The lack of standardized objective assessment of esophageal physiology and anatomy contributes to the controversies regarding the impact of SG and RYGB on gastroesophageal reflux disease.<BR><B>METHODS: </B>We conducted a systematic review and meta-analysis of studies reporting at least one objective measure of esophageal physiology and/or EGD, at baseline and after SG or RYGB. The changes in pH-test, manometry, and EGD parameters were summarized.<BR><B>RESULTS: </B>Acid exposure time (AET) and DeMeester Score (DMS) significantly increased after SG: Mean Difference (MD) 2.1 (95%CI 0.3 to 3.9) and 8.6 (95%CI 2 to 15.2), respectively. After RYGB, both AET and DMS significantly decreased: MD -4.2 (95%CI -6.1 to -2.3) and - 16.6 (95%CI -25.4 to -7.8). Lower esophageal sphincter resting pressure and length significantly decreased following SG: MD - 2.8 (95%CI - 4.6 to - 1.1) and - 0.1 (95%CI - 0.2 to - 0.02), respectively. There were no significant changes in esophageal manometry after RYGB. The Relative Risk of erosive esophagitis after SG was 2.3 (95%CI 1.5 to 3.5), while after RYGB it was 0.4 (95%CI 0.2 - 0.8). The prevalence of Barrett's Esophagus changed from 0% to 3.6% after SG, and from 2.7% to 1.4% after RYGB.<BR><B>CONCLUSIONS: </B>SG resulted in worsening of all objective parameters, while RYGB showed improvement in AET, DMS, and EGD findings. Determining the risk factors associated with those outcomes could aid in surgical choice.