Memon, Muhammed Ashraf and Osland, Emma and Yunus, Rossita Mohamad and Hoque, Zahirul and Alam, Khorshed and Khan, Shahjahan (2024) The effect of laparoscopic vertical sleeve gastrectomy and laparoscopic roux-en-Y gastric bypass on gastroesophageal reflux disease: An updated meta-analysis and systematic review of 5-year post-operative data from randomized controlled trials. Surgical Endoscopy and Other Interventional Techniques, 38 (11). pp. 6254-6269. ISSN 0930-2794, DOI https://doi.org/10.1007/s00464-024-11303-x.
Full text not available from this repository.Abstract
BackgroundTo evaluate 5-year effect of laparoscopic vertical sleeve gastrectomy (LVSG) versus laparoscopic roux-en-Y gastric bypass (LRYGB) on gastroesophageal reflux disease (GERD) solely based on randomized controlled trials (RCTs).MethodsA systematic review and meta-analysis of 5-year postoperative GERD data comparing LVSG and LRYGB in adults were undertaken. Electronic databases were searched from January 2015 to March 2024 for publications meeting inclusion criteria. The Hartung-Knapp-Sidik-Jonkman random effects model was applied to estimate pooled odds ratio where meta-analysis was possible. Bias and certainty of evidence were assessed using the Cochrane Risk of Bias Tool 2 and GRADE.ResultsFive RCTs were analysed (LVSG n = 554, LRYGB n = 539). LVSG was associated with increased adverse GERD outcomes compared to LRYGB at 5 years. The odds for revisional surgery to treat GERD in LVSG patients were 11 times higher compared to LRYGB (OR 11.47, 95% CI 1.83 to 71.69; p = 0.02; I2 = 0% High level of certainty). Similarly pharmacological management for increasing GERD was significantly more frequent in LVSG patients compared to LRYGB (OR 3.89, 95% CI 2.31 to 6.55; p <= 0.01; I2 = 0% Moderate level of certainty). Overall, LVSG was associated with significantly more interventions (both medical and surgical) for either worsening GERD and/or development of de novo GERD compared to LRYGB (OR 5.98, 95% CI 3.48 to 10.29; p <= 0.01; I2 = 0%) Moderate level of certainty).ConclusionsThe development and worsening of GERD symptoms are frequently associated with LVSG compared to LRYGB at 5 years postoperatively requiring either initiation or increase of pharmacotherapy or failing that revisional bariatric surgery. Appropriate patient/surgical selection is crucial to reduce these postoperative risks of GERD.
| Item Type: | Article |
|---|---|
| Funders: | CAUL |
| Uncontrolled Keywords: | Bariatric surgery; Gastroesophageal reflux disease; Laparoscopic; Roux-en-Y gastric bypass; Sleeve gastrectomy; Meta-analysis; Systematic review |
| Subjects: | R Medicine > RD Surgery |
| Divisions: | Faculty of Science > Institute of Mathematical Sciences |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 17 Feb 2025 01:55 |
| Last Modified: | 17 Feb 2025 01:55 |
| URI: | http://eprints.um.edu.my/id/eprint/47426 |
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