Esophageal motility and reflux symptoms before and after bariatric surgery.
BACKGROUND
Surgical treatment is the most effective method for weight reduction in morbid obesity. The most common operations are gastric banding and gastric bypass. The effect of these interventions on esophageal function and gastroesophageal reflux symptoms has not been adequately investigated.


METHODS
Patients undergoing obesity surgery were prospectively included in an observational study. Before surgery, each of the 53 patients underwent pulmonary function tests, esophageal manometry, and gastroscopy. Drug medication and esophageal symptoms were recorded. "Non-sweet eater" patients with good compliance underwent laparoscopic adjustable gastric banding (LAGB). In "sweet-eating" or non-compliant patients, gastric bypass (GBP) was carried out.


RESULTS
Between July 1997 and April 2000, 53 patients (9 males and 44 females) were consecutively operated on. 32 patients (median BMI 46.4 kg/m2 +/- 5.4 SD) received LAGB, and 21 patients (BMI 54.0 kg/m2 +/- 10.7) GBP. Median follow-up was 22 months, and only 3 patients were lost to yearly follow-up. Preoperatively, 6 LAGB patients had reflux symptoms, which postoperatively resolved in 3 of them, while the other 3 noted no change. Three patients who had no preoperative reflux symptoms developed them after LAGB. In the GBP group, no patient had esophageal dysmotility or incompetent esophageal sphincter function pre- or postoperatively. The incidence of postoperative esophageal symptoms was independent of operative technique (Wilcoxon U-Test: p = 0.75).


CONCLUSIONS
The present results do not show any effect of gastric reduction surgery on postoperative esophageal function or gastroesophageal reflux symptoms.
Korenkov
Michael
M
Surgical Clinic, 2nd Department of Surgery, University of Cologne, Ostmerheimer Strasse 200, D-51109 Cologne, Germany. michael.korenkov@uni-koeln.de
Köhler
Lothar
L
Yücel
Nedim
N
Grass
Guido
G
Sauerland
Stefan
S
Lempa
Maria
M
Troidl
Hans
H
D000328:Adult; D004947:Esophagus / Q000502:physiology* / Q000503:physiopathology; D005260:Female; D015390:Gastric Bypass; D005764:Gastroesophageal Reflux / Q000150:complications / Q000628:therapy*; D015391:Gastroplasty; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications; D011446:Prospective Studies