Histological esophagitis before and after surgical treatment of morbid obesity (Capella technique): a prospective study.
BACKGROUND
The effects of vertical banded gastroplasty/Roux-en-Y gastric bypass (Capella) on the esophageal mucosa of patients with histological esophagitis are poorly understood. To evaluate long-term effects, we investigated the persistence, aggravation or disappearance of histological esophagitis in patients with morbid obesity and reflux esophagitis (diagnosed by endoscopic biopsy) after Roux-en-Y gastric bypass.


METHODS
Twenty-one patients with morbid obesity and esophagitis (histological diagnosis) were submitted to gastric bypass (Fobi-Capella technique) and underwent upper endoscopy and esophageal biopsy during the late postoperative period.


RESULTS
The mean age of the patients was 42.57 +/- 7.49 years (30 to 56). Nineteen (90.48%) patients were women, and two (9.52%) were men. Before surgery, the patients presented a mean weight of 124.26 +/- 19.09 kg and a mean body mass index (BMI) of 48.46 +/- 6.37 kg/m(2). Thirteen (61.90%) patients had endoscopic esophagitis before surgery. The mean weight and BMI were 81.65 +/- 13.16 kg and 31.91 +/- 4.99 kg/m(2), respectively, during the late postoperative period (29.80 +/- 8.91 months). The mean percentage of excess weight loss was 68.7 +/- 14.6%. Among the 21 patients with a preoperative histological diagnosis of reflux esophagitis, five (23.18%) had the same diagnosis after surgery, and four (19.04%) continued to present findings of endoscopic esophagitis.


CONCLUSIONS
Vertical banded gastroplasty/Roux-en-Y gastric bypass (Capella technique) is effective in the treatment of reflux esophagitis. No association was observed between the percentage of excess weight loss and improvement of esophagitis.
Reis
Galzuinda Maria Figueiredo
GM
Santa Casa de Misericórdia de Belo Horizonte, Universidade Federal de Minas Gerais, Av.Contorno, 4747, sala 1108-1109, 30110-090 Belo Horizonte, MG, Brazil. gal@gal.med.br
Savassi-Rocha
Paulo Roberto
PR
Nogueira
Ana Margarida M F
AM
Lima
Marcílio José Rodrigues
MJ
de Carvalho
Silas
S
Arantes
Vitor
V
Barros
Carlos Alberto
CA
Cançado
Omar Lopes
OL
D000328:Adult; D015992:Body Mass Index; D004942:Esophagitis, Peptic / Q000209:etiology / Q000473:pathology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D009767:Obesity, Morbid / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss