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 Spread of deadly eye cancer halted in cells and animals
13.11.2018 | Johns Hopkins Medicine

nachricht Breakthrough in understanding how deadly pneumococcus avoids immune defenses
13.11.2018 | University of Liverpool

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: A Chip with Blood Vessels

Biochips have been developed at TU Wien (Vienna), on which tissue can be produced and examined. This allows supplying the tissue with different substances in a very controlled way.

Cultivating human cells in the Petri dish is not a big challenge today. Producing artificial tissue, however, permeated by fine blood vessels, is a much more...

Im Focus: A Leap Into Quantum Technology

Faster and secure data communication: This is the goal of a new joint project involving physicists from the University of Würzburg. The German Federal Ministry of Education and Research funds the project with 14.8 million euro.

In our digital world data security and secure communication are becoming more and more important. Quantum communication is a promising approach to achieve...

Im Focus: Research icebreaker Polarstern begins the Antarctic season

What does it look like below the ice shelf of the calved massive iceberg A68?

On Saturday, 10 November 2018, the research icebreaker Polarstern will leave its homeport of Bremerhaven, bound for Cape Town, South Africa.

Im Focus: Penn engineers develop ultrathin, ultralight 'nanocardboard'

When choosing materials to make something, trade-offs need to be made between a host of properties, such as thickness, stiffness and weight. Depending on the application in question, finding just the right balance is the difference between success and failure

Now, a team of Penn Engineers has demonstrated a new material they call "nanocardboard," an ultrathin equivalent of corrugated paper cardboard. A square...

Im Focus: Coping with errors in the quantum age

Physicists at ETH Zurich demonstrate how errors that occur during the manipulation of quantum system can be monitored and corrected on the fly

The field of quantum computation has seen tremendous progress in recent years. Bit by bit, quantum devices start to challenge conventional computers, at least...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

“3rd Conference on Laser Polishing – LaP 2018” Attracts International Experts and Users

09.11.2018 | Event News

On the brain’s ability to find the right direction

06.11.2018 | Event News

European Space Talks: Weltraumschrott – eine Gefahr für die Gesellschaft?

23.10.2018 | Event News

 
Latest News

The dawn of a new era for genebanks - molecular characterisation of an entire genebank collection

13.11.2018 | Life Sciences

Fish recognize their prey by electric colors

13.11.2018 | Life Sciences

Ultrasound Connects

13.11.2018 | Awards Funding

VideoLinks
Science & Research
Overview of more VideoLinks >>>