title: The evaluation of pyrosis and long-term satisfaction after gastric restrictive procedures: a retrospective study.
abstract: 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.
authors.affiliation: Department of abdominal surgery, University Hospital of Antwerp, Belgium.
authors.forename: B
authors.initials: B
authors.lastname: Balduyck
authors.forename: S
authors.initials: S
authors.lastname: Vansteenkiste
authors.forename: M
authors.initials: M
authors.lastname: Ruppert
authors.forename: L
authors.initials: L
authors.lastname: Balliu
authors.forename: W
authors.initials: W
authors.lastname: Vaneerdeweg
authors.forename: G
authors.initials: G
authors.lastname: Hubens
mesh_terms: 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