Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Gastric bypass works for GERD and obesity in patients with prior surgery

15.11.2004


Laparoscopic gastric bypass surgery can effectively control gastroesophageal reflux disease (GERD) symptoms in morbidly obese patients who had previous antireflux surgery, with the additional benefit of weight loss and improvement of co-morbidities, according to a study published in the November issue of the journal Obesity Surgery.



The University of Pittsburgh School of Medicine study found that gastric bypass is feasible and effective in controlling GERD in patients who had previous antireflux surgery and who have subsequently gained significant weight, and in obese patients who have had previous antireflux procedures and continued to have problems with GERD.

This small study involved seven patients who underwent laparoscopic gastric bypass after having antireflux surgery to control GERD. Patients’ co-morbid medical conditions included sleep apnea, diabetes mellitus, hypertension, degenerative joint disease, depression, hypercholesterolemia, polycystic ovarian syndrome and lower extremity edema. "Despite a morbidity rate of 42.8 percent, this study showed that all patients did well with zero mortality and were satisfied with their condition during the follow-up period, suggesting that the long-term outcome of laparoscopic gastric bypass in obese patients who had previous antireflux surgery is promising. There also was a significant improvement of GERD symptoms following the laparoscopic gastric bypass, which was maintained during follow-up," said Ioannis Raftopoulos, M.D., Ph.D., assistant professor of surgery in the division of thoracic & foregut surgery at the University of Pittsburgh School of Medicine, and principal author of the study. In addition, 70 percent of associated co-morbid medical conditions were either resolved or improved significantly.


GERD is a significant public health problem affecting up to 40 percent of the American adult population. "Although a direct cause-effect relationship between obesity and GERD has not been clearly established, obesity is often associated with GERD. Up to 55 percent of morbidly obese patients presenting for laparoscopic Roux-en-Y gastric bypass have symptoms of chronic GERD," said James D. Luketich, M.D., professor of surgery, chief of the division of thoracic & foregut surgery, co-director of the Mark Ravitch/Leon C. Hirsch Center for Minimally Invasive Surgery, and senior author of the study.

Laparoscopic gastric bypass after antireflux surgery is a technically more difficult procedure, which is reflected in the prolonged operative time (mean 372 min.) and length of hospital stay (mean 4.8 days). "It is important to emphasize that success rates for first time redo antireflux surgery, which would be the alternative to laparoscopic gastric bypass, range between 60 percent and 80 percent and fall to 50 percent for second time redo antireflux surgery," Dr. Raftopoulos said. "In addition, redo antireflux surgery is not associated with weight loss. In contrast, patients with prior antireflux surgery enjoyed a 70.7 percent excess weight loss after laparoscopic gastric bypass at a mean follow-up of 24 months, which translated into a postoperative reduction of body mass index from 37.5 kg/m2 to 26.8 kg/m2."

"This degree of weight loss is equal to that experienced by patients who undergo gastric bypass surgery primarily for obesity, and is enough to impact dramatic improvements in obesity-related co-morbid medical conditions." said Anita P. Courcoulas, M.D., assistant professor of surgery, and director of bariatric surgery at UPMC Shadyside, and a co-author of the study.

In summary, laparoscopic gastric bypass appears to be a better alternative for the morbidly obese patient with GERD and previous antireflux surgery, who 1) remains symptomatic after the first fundoplication, or 2) qualifies for gastric bypass surgery.

Frank Raczkiewicz | EurekAlert!
Further information:
http://www.upmc.edu

More articles from Health and Medicine:

nachricht Plasmonic biosensors enable development of new easy-to-use health tests
14.12.2017 | Aalto University

nachricht ASU scientists develop new, rapid pipeline for antimicrobials
14.12.2017 | Arizona State University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Long-lived storage of a photonic qubit for worldwide teleportation

MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.

Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...

Im Focus: Electromagnetic water cloak eliminates drag and wake

Detailed calculations show water cloaks are feasible with today's technology

Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...

Im Focus: Scientists channel graphene to understand filtration and ion transport into cells

Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.

To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...

Im Focus: Towards data storage at the single molecule level

The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.

Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...

Im Focus: Successful Mechanical Testing of Nanowires

With innovative experiments, researchers at the Helmholtz-Zentrums Geesthacht and the Technical University Hamburg unravel why tiny metallic structures are extremely strong

Light-weight and simultaneously strong – porous metallic nanomaterials promise interesting applications as, for instance, for future aeroplanes with enhanced...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

AKL’18: The opportunities and challenges of digitalization in the laser industry

07.12.2017 | Event News

 
Latest News

Plasmonic biosensors enable development of new easy-to-use health tests

14.12.2017 | Health and Medicine

New type of smart windows use liquid to switch from clear to reflective

14.12.2017 | Physics and Astronomy

BigH1 -- The key histone for male fertility

14.12.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>