Objective:

To compare the effects of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) on esophageal function and the development of gastroesophageal reflux disease (GERD) in patients with severe obesity, highlighting the clinical significance of these comparisons.

Key Findings:

• LSG may increase the incidence of GERD due to factors like weakened lower esophageal sphincter and increased intragastric pressure, which could impact patient management strategies.
• LRYGB is more effective in managing GERD, reducing acid secretion and bile diversion, suggesting a preferred surgical option for patients with GERD.
• De novo GERD is less frequent after LRYGB compared to LSG, indicating a need for careful patient selection.

Interpretation:

The study highlights the complex relationship between bariatric surgery types and GERD outcomes, suggesting LRYGB as a superior option for patients with severe obesity and GERD, with implications for surgical decision-making.

Limitations:

• Small sample size of 30 patients may limit the generalizability of the findings; non-randomized design may introduce selection bias, potentially affecting the reliability of the results.

Conclusion:

LRYGB is more effective than LSG in improving esophageal function and managing GERD in patients with severe obesity, underscoring the need for tailored surgical approaches.