TY - JOUR
T1 - Reflux and Barrett's esophagus after sleeve gastrectomy
T2 - analysis of a statewide database
AU - Swei, Eric
AU - Helmkamp, Laura
AU - Samuels, Jason
AU - Schoen, Jonathan
AU - Scott, Frank I.
AU - Wani, Sachin
AU - Sullivan, Shelby
N1 - Funding Information:
This work was supported by National Institutes of Health (NIH)/National Center for Advancing Translational Sciences Colorado Clinical and Translational Sciences Institute Grant UL1 TR002535 and by the National Institute of Diabetes and Digestive and Kidney Disease of the NIH under Award Number DK007038-45. Contents are the authors’ sole responsibility and do not necessarily represent official NIH views.
Publisher Copyright:
© 2023 American Society for Metabolic and Bariatric Surgery
PY - 2023/9
Y1 - 2023/9
N2 - Background: Recent studies have suggested that sleeve gastrectomy (SG) is associated with the development of Barrett esophagus (BE) even in the absence of gastroesophageal reflux disease (GERD) symptoms. Objective: The aim of this study was to assess the rates of upper endoscopy and incidence of new BE diagnoses in patients undergoing SG. Setting: This was a claims-data study of patients who underwent SG between 2012 and 2017 while enrolled in a U.S. statewide database. Methods: Diagnostic claims data were used to identify pre- and postoperative rates of upper endoscopy, GERD, reflux esophagitis, and BE. Time-to-event analysis using a Kaplan-Meier approach was performed to estimate the cumulative postoperative incidence of these conditions. Results: We identified 5562 patients who underwent SG between 2012 and 2017. Of these, 1972 patients (35.5%) had at least 1 diagnostic record of upper endoscopy. The preoperative incidences of a diagnosis of GERD, esophagitis, and BE were 54.9%, 14.6%, and .9%, respectively. The predicted postoperative incidences of GERD, esophagitis, and BE, respectively, were 18%, 25.4%, and 1.6% at 2 years and 32.1%, 85.0%, and 6.4% at 5 years. Conclusions: In this large statewide database, rates of esophagogastroduodenoscopy remained low after SG, but the incidence of a new postoperative esophagitis or BE diagnosis in patients who underwent esophagogastroduodenoscopy was higher than in the general population. Patients undergoing SG may have a disproportionately high risk of developing reflux complications including BE after surgery.
AB - Background: Recent studies have suggested that sleeve gastrectomy (SG) is associated with the development of Barrett esophagus (BE) even in the absence of gastroesophageal reflux disease (GERD) symptoms. Objective: The aim of this study was to assess the rates of upper endoscopy and incidence of new BE diagnoses in patients undergoing SG. Setting: This was a claims-data study of patients who underwent SG between 2012 and 2017 while enrolled in a U.S. statewide database. Methods: Diagnostic claims data were used to identify pre- and postoperative rates of upper endoscopy, GERD, reflux esophagitis, and BE. Time-to-event analysis using a Kaplan-Meier approach was performed to estimate the cumulative postoperative incidence of these conditions. Results: We identified 5562 patients who underwent SG between 2012 and 2017. Of these, 1972 patients (35.5%) had at least 1 diagnostic record of upper endoscopy. The preoperative incidences of a diagnosis of GERD, esophagitis, and BE were 54.9%, 14.6%, and .9%, respectively. The predicted postoperative incidences of GERD, esophagitis, and BE, respectively, were 18%, 25.4%, and 1.6% at 2 years and 32.1%, 85.0%, and 6.4% at 5 years. Conclusions: In this large statewide database, rates of esophagogastroduodenoscopy remained low after SG, but the incidence of a new postoperative esophagitis or BE diagnosis in patients who underwent esophagogastroduodenoscopy was higher than in the general population. Patients undergoing SG may have a disproportionately high risk of developing reflux complications including BE after surgery.
KW - Barrett esophagus after sleeve gastrectomy
KW - Endoscopy after bariatric surgery
KW - Reflux after bariatric surgery
KW - Reflux after sleeve gastrectomy
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U2 - 10.1016/j.soard.2023.02.008
DO - 10.1016/j.soard.2023.02.008
M3 - Article
C2 - 36948973
AN - SCOPUS:85150786159
SN - 1550-7289
VL - 19
SP - 1023
EP - 1029
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
IS - 9
ER -