To evaluate the prevalence, perioperative safety, and predictors of serious complications, specifically anastomotic leaks, postoperative bleeding, and other events, in patients undergoing Sleeve Gastrectomy (SG) or Roux-en-Y Gastric Bypass (RYGB) after previous fundoplication.
Key Findings:
RYGB showed higher symptom resolution rates and lower recurrence of reflux compared to redo fundoplication, suggesting it may be a more effective option.
SG may exacerbate GERD but can be performed safely in selected patients post-fundoplication, highlighting the need for careful patient selection.
Limited comparative safety and outcomes data exist for SG and RYGB in revisional contexts, indicating a need for further research.
Interpretation:
RYGB is a favorable option for patients with obesity and GERD post-fundoplication, while SG may be considered in select cases despite potential GERD exacerbation; patient selection criteria should be clearly defined.
Limitations:
Lack of detailed information on specific types of fundoplication performed may affect the analysis.
Data restricted to a specific timeframe may limit generalizability, and potential biases inherent in retrospective analysis should be acknowledged.
Conclusion:
RYGB is recommended over SG for patients with obesity and GERD after failed fundoplication due to better safety profiles and outcomes; careful patient selection is crucial.
by Pattharasai Kachornvitaya, Valentin Mocanu, Mélissa V. Wills, Juan S. Barajas-Gamboa, Salvador Navarrete, Ricard Corcelles, Andrew Strong, Suthep Udomsawaengsup, Matthew Kroh, Jerry Dang
