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Tailoring Surgical Treatment for the Individual Patient

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Abstract

Bariatric surgery numbers have changed over time in the USA. Sleeve gastrectomy (SG) has gained popularity during the last years, leaving Roux-en-Y gastric bypass (RYGB) behind in terms of numbers. The objective of this chapter is to analyze the reason for this change, while evaluating outcomes related to type 2 diabetes, weight loss, complications, and gastroesophageal reflux disease (GERD). It seems that RYGB would be more beneficial for obese patients with type 2 diabetes, showing better weight loss, and resolution of GERD. Complication rates are higher for RYGB; nevertheless, complications after SG are sometimes difficult to deal with.

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References

  1. https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers.

  2. Mason EE, Ito C. Gastric bypass in obesity. Surg Clin North Am. 1967;47(6):1345–51.

    Article  CAS  Google Scholar 

  3. Regan JP, Inabnet WB, Gagner M, Pomp A. Early experience with a two-stage laparoscopic Roux-en- Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13(6):861–4.

    Article  CAS  Google Scholar 

  4. Clinical Issues Committee of the American Society for Metabolic and Bariatric Surgery. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis. 2010;6(1):1–5.

    Article  Google Scholar 

  5. Clinical Issues Committee of the American Society for Metabolic and Bariatric Surgery. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis. 2012;8(3):e21–6.

    Article  Google Scholar 

  6. American Society for Metabolic and Bariatric Surgery Clinical Issues Committee. American Society for Metabolic and Bariatric Surgery updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis. 2017;13(10):1652–7.

    Article  Google Scholar 

  7. Gastrointestinal Surgery for Obesity. National Institutes of Health consensus development conference statement. Am J Clin Nutr. 1992;55:615S–9S.

    Article  Google Scholar 

  8. Schauer P, Bhatt D, Kirwan J, Wolski K, Aminian A, Brethauer S, et al. Bariatric surgery versus intensive medical therapy for diabetes — 5-year outcomes. N Engl J Med. 2017;376(7):641–51.

    Article  Google Scholar 

  9. Li JF, Lai DD, Ni B, Sun KX. Comparison of laparoscopic Roux -en- Y gastric bypass with laparoscopic sleeve gastrectomy for morbid obesity or type 2 diabetes mellitus: a meta-analysis of randomized controlled trials. Can J Surg. 2013;56(6):E158–64.

    Article  Google Scholar 

  10. Peterli R, Wölnerhanssen BK, Peters T, Vetter D, Kröll D, Bornély Y, Schultes B, Beglinger C, Drewe J, Schiesser M, Nett P, Bueter M. Effect of laparoscopic sleeve gastrectomy vs. laparoscopic Roux-en- Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS Randomized Clinical Trial. JAMA. 2018;319(3):255–65.

    Article  Google Scholar 

  11. Salminen P, Helmiö M, Ovaska J, Juuti A, Leivonen M, Peromaa-Haavisto P, Hurme S, Soinio M, Nuutila P, Victorzon M. Effect of laparoscopic sleeve gastrectomy vs. laparoscopic Roux -en- Y gastric bypass on weight loss at 5 years among patients with morbid obesity: the SLEEVEPASS randomized clinical trial. JAMA. 2018;319(3):241–54.

    Article  Google Scholar 

  12. Shoar S, Saber A. Long-term and midterm outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass: a systematic review and meta-analysis of comparative studies. Surg Obes Relat Dis. 2017;13(2):170–80.

    Article  Google Scholar 

  13. Zellmer JD, Mathiason MA, Kallies KJ, Kothari SN. Is the laparoscopic sleeve gastrectomy a lower risk bariatric procedure compared with laparoscopic Roux-en- Y gastric bypass? A meta-analysis. Am J Surg. 2014;208(6):903–10.

    Article  Google Scholar 

  14. Kumar SB, Hamilton BC, Wood SG, Rogers SJ, Carter JT, Lin MY. Is the laparoscopic sleeve gastrectomy safer that laparoscopic gastric bypass? A comparison of 30-day complications using the MBSAQIP data registry. Surg Obes Relat Dos. 2018;14(3):264–9.

    Article  Google Scholar 

  15. Galvani C, Fisichella PM, Gorodner MV, Perretta S, Patti MG. Symptoms are poor indicator of reflux disease after fundoplication for gastroesophageal reflux disease: role of esophageal function tests. Arch Surg. 2003;138(5):514–8.

    Article  Google Scholar 

  16. Burgerhart JS, Charlotte AI, Schotborgh SEJ, Smulders JF, van de Meeberg PC, Siersema PD, Smout AJ. Effect of sleeve gastrectomy on gastroesophageal reflux. Obes Surg. 2014;24:1436.

    Article  Google Scholar 

  17. Del Genio G, Tolone S, Limongelli P, Brusciano L, D’Alessandro A, Docimo G, Rossetti G, Silecchia G, Ianelli A, del Genio A, del Genio F, Docimo L. Sleeve gastrectomy and development of “de novo” gastroesophageal reflux. Obes Surg. 2014;24(1):71–7.

    Article  Google Scholar 

  18. Thereaux J, Barsamian C, Bretault M, Dusaussoy H, Lamargue D, Bouillot JL, Czernichow S, Carette C. pH monitoring of gastro-oesophageal reflux before and after laparoscopic sleeve gastrectomy. Br J Surg. 2016;103(4):399–406.

    Article  CAS  Google Scholar 

  19. Gorodner V, Buxhoeveden R, Clemente G, Sole L, Caro L, Grigaites A. Does laparoscopic sleeve gastrectomy have any influence on gastroesophageal reflux disease? Preliminary results. Surg Endosc. 2015;29(7):1760–8.

    Article  Google Scholar 

  20. Rebecchi F, Allaix ME, Giaccone C, Ugliono E, Morino M. Gastroesophageal reflux disease and laparoscopic sleeve gastrectomy: a physiopathologic evaluation. Ann Surg. 2014;260(5):909–14; discussion 914–5

    Article  Google Scholar 

  21. Genco A, Soricelli E, Casella G, Maselli R, Catagneto-Gissey L, Di Lorenzo N, Basso N. Gastroesophageal reflux disease and Barrett’s esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication. Surg Obes Relat Dis. 2017;13(4):568–74.

    Article  Google Scholar 

  22. Mejia-Rivas MA, Herrera-Lopez A, Hernandez-Calleros J, Herrera MF, Valdovinos MA. Gastroesophageal reflux disease in morbid obesity: the effect of Roux-en-Y gastric bypass. Obes Surg. 2008;18(10):1217–24.

    Article  Google Scholar 

  23. Madalosso CA, Gurski RR, Callegari-Jacques SM, Navarini D, Mazzini G, Pereira MS. The impact of gastric bypass on gastroesophageal reflux disease in morbidly obese patients. Ann Surg. 2016;263(1):110–6.

    Article  Google Scholar 

  24. Gorodner V, Buxhoeveden R, Clemente G, Sanchez C, Caro L, Grigaites A. Barrett’s esophagus after Roux-En- Y gastric bypass: does regression occur? Surg Endosc. 2017;31(4):1849–54.

    Article  Google Scholar 

  25. Bendewald FP, Choi JN, Blythe LS, Selzer DJ, Ditslear JH, Mattar SG. Comparison of hand-sewn, linear-stapled, and circular-stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2011;21(11):1671–5.

    Article  Google Scholar 

  26. Caro L, Sanchez C, Rodriguez P, Bosch J. Endoscopic balloon dilatation of anastomosis strictures occurring after laparoscopic gastric bypass for morbid obesity. Dig Dis. 2008;26(4):314–7.

    Article  Google Scholar 

  27. Rodríguez A, Mosti M, Sierra M, Pérez-Johnson R, Flores S, Dominguez G, Sanchez H, Zarco A, Romay K, Herrera MF. Small bowel obstruction after antecolic and antegastric laparoscopic Roux-en-Y gastric bypass: could the incidence be reduced? Obe Surg. 2010;20(10):1380–4.

    Article  Google Scholar 

  28. Geubbels N, Lijftogt N, Fiocco M, van Leersum NJ, Wouters MW, de Brauw LM. Meta-analysis of internal herniation after gastric bypass surgery. Br J Surg. 2015;102(5):451–60.

    Article  CAS  Google Scholar 

  29. Saltzman E, Karl JP. Nutrient deficiencies after gastric bypass surgery. Annu Rev Nutr. 2013;33:183–203.

    Article  CAS  Google Scholar 

  30. Ben-Porat T, Elazary R, Goldenshluger A, Sherf Dagan S, Mintz Y, Weiss R. Nutritional deficiencies four years after laparoscopic sleeve gastrectomy-are supplements required for a lifetime? Surg Obes Relat Dis. 2017;13(7):1138–44.

    Article  Google Scholar 

  31. Ramadan M, Loureiro M, Laughlan K, Caizazzo R, Iannelli A, Brunaud L, Czernichow S, Nedelcu M, Nocca D. Risk of dumping syndrome after sleeve gastrectomy and Roux-en- Y gastric bypass: early results of a multicentre prospective study. Gastroenterol Res Pract. 2016;2016:2570237.

    Article  CAS  Google Scholar 

  32. Schauer P, Ikramuddin S, Hamad G, Gourash W. The learning curve for laparoscopic Roux-en-Y gastric bypass is 100 cases. Surg Endosc. 2003;17(2):212–5.

    Article  CAS  Google Scholar 

  33. Nelson LG, Gonzalez R, Haines K, Gallagher SF, Murr MM. Amelioration of gastroesophageal reflux symptoms following Roux-en-Y gastric bypass for clinically significant obesity. Am Surg. 2005;71:950–3; discussion 953–4

    PubMed  Google Scholar 

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Gorodner, V., Di Corpo, M., Schlottmann, F. (2020). Tailoring Surgical Treatment for the Individual Patient. In: Patti, M., Di Corpo, M., Schlottmann, F. (eds) Foregut Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-27592-1_30

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  • DOI: https://doi.org/10.1007/978-3-030-27592-1_30

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-27591-4

  • Online ISBN: 978-3-030-27592-1

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