The evaluation of pyrosis and long-term satisfaction after gastric restrictive procedures: a retrospective study.
OBJECTIVE
To compare gastric banding (GB) and vertical banded gastroplasty (VBG) with respect to the evolution of pyrosis and patient satisfaction.


BACKGROUND
Although weight loss is the most immediate end-point in the evaluation of surgical treatment of obesity, the demonstration of changes in long-term patient satisfaction and in co-morbidity, like reflux, is an essential outcome measure.


METHODS
Retrospective study of 243 morbidly obese patients. All patients received a questionnaire regarding the evolution of pyrosis and their satisfaction after surgery. The evolution of pyrosis was compared between 2 patient groups who had different oesophagitis stages. Group A had oesophagitis I, or no oesophagitis, and group B had oesophagitis II, III or IV.


RESULTS
In group A of the GB group 57.8% had no complaints, 11.1% had improvement and 22.2% had aggravation of the pyrosis. In group B of the GB group 50.0% had improvement. In group A of the VBG group 51.4% had no complaints, 11.1% improvement and 23.6% aggravation of the pyrosis. In group B of the VBG group 16.7% had no complaints, 66.6% had improvement and 16.7% had aggravation of the pyrosis complaints. Statistically there is no significant difference between GB and VBG. The experience after GB is good with 67.9%, mediocre with 25.0% and bad with 7.1% of the patients ; 60.7% is pleased with the weight loss. The experience after VBG is good with 47.4%, mediocre with 29.5% and bad with 23.1% of the patients. 52.6% is satisfied with the weight loss.


CONCLUSIONS
VBG and GB have a similar effect on pyrosis. From our point of view it has been evidenced that the presence or absence of pyrosis before the operation is a possible predictor of the evolution afterwards. Long-term patient satisfaction is the same after GB and VBG. Other factors influence the satisfaction.
Balduyck
B
B
Department of abdominal surgery, University Hospital of Antwerp, Belgium.
Vansteenkiste
S
S
Ruppert
M
M
Balliu
L
L
Vaneerdeweg
W
W
Hubens
G
G
D000328:Adult; D017677:Age Distribution; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D015905:Gastric Balloon / Q000009:adverse effects; D005764:Gastroesophageal Reflux / Q000453:epidemiology* / Q000209:etiology; D015391:Gastroplasty / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D006356:Heartburn / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D016017:Odds Ratio; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D016896:Treatment Outcome; D015431:Weight Loss