title: Incidence of regurgitation after the banded gastric bypass.
abstract: BACKGROUND
  Frequent regurgitation is a common complication following Roux-en-Y gastric bypass (RYGBP). This study investigated the risk of becoming a chronic regurgitator, by considering silicone ring size and lower esophageal sphincter (LES) function, and their relationship with weight loss.
  
  
  METHODS
  80 morbidly obese patients were randomly selected to undergo surgery using ring length of 62 mm (40 patients, group A) or 77 mm (40 patients, group B), with 6 months' postoperative follow-up. Preoperative esophageal manometry parameters were correlated with occurrence of chronic postoperative regurgitation. Patients were considered to present chronic regurgitation when this occurred on >10 days/month.
  
  
  RESULTS
  The groups were homogeneous regarding age, gender, race, weight, BMI (47.8+/-6.1 vs 50.2+/-6.4 kg/m2) and obesity-related diseases. There were 15% more chronic regurgitators in group A than in group B. Chronic regurgitators in group A lost more weight than chronic regurgitators in group B (P=0.026) or non-chronic regurgitators in group A (P=0.016). A greater proportion of chronic regurgitators had LES hypotonia (mean respiratory pressure <14 mmHg) than did non-chronic regurgitators (P=0.008). Logistic regression demonstrated that the chance of being a chronic regurgitator in group A was 4.5 times greater than in group B (P=0.046), and that the chance of a chronic regurgitator having LES hypotonia was seven times greater than of having normal LES pressure (P=0.006).
  
  
  CONCLUSIONS
  Silicone ring size and LES hypotonia are independent prognostic factors for chronic regurgitation following RYGBP. Ring size and chronic regurgitation contribute significantly towards weight loss during the first 6 postoperative months.
authors.affiliation: Department of Surgery, Federal University of São Paulo, Escola Paulista de Medicina, São Paulo, Brazil. haruo@osite.com.br
authors.forename: Carlos Haruo
authors.initials: CH
authors.lastname: Arasaki
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Del Grande
authors.forename: Edison Takehiko
authors.initials: ET
authors.lastname: Yanagita
authors.forename: Ana Karina Soares
authors.initials: AK
authors.lastname: Alves
authors.forename: Daniel Riccioppo C F
authors.initials: DR
authors.lastname: Oliveira
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004867:Equipment Design; D049630:Esophageal Sphincter, Lower / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects*; D015391:Gastroplasty / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D015994:Incidence; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011312:Pressure; D011446:Prospective Studies; D012828:Silicones; D016037:Single-Blind Method; D016896:Treatment Outcome; D014839:Vomiting / Q000453:epidemiology / Q000209:etiology*; D015431:Weight Loss
chemical_list: D012828:Silicones