Supplementary Table 3 | Roux-en-Y gastric bypass and relationship with oesophageal disease
Study
Year
Type of
study
Retrospectiv
e trial
Patients
Evaluation
Symptom reporting
Follow-up
(months)
36
Oesophageal
issue
GERD
Frezza
2002
152
Clements
2003
Prospective
analysis
Prospective
analysis
Retrospectiv
e trial
43
Symptom scoring
6
Dysphagia
Foster
2003
43
Symptom scoring
6
Dysphagia
Ortega
2004
40
Symptom reporting,
oesophageal
manometry and 24hour pH monitoring,
isotopic
oesophageal
emptying
Symptom reporting
via use of PPI
12
GERD
Perry et al.S5
2004
Retrospectiv
e trial
57
18
GERD
Nelson
2005
Prospective
trial
606
Symptom reporting
9
GERD
Merrouche
2007
Prospective
analysis
100
35
Oesophageal
dyskinesia
2008
Retrospectiv
e trial
20
6
GERD
Madalosso
2010
Prospective
trial
86
6
GERD
Kehagias
2011
Randomized
controlled
trial
Prospective
trial
30
Symptom scoring,
endoscopy,
manometry, 24hour pH monitoring
Symptom reporting,
oesophageal
manometry and pH
monitoring, time of
pH<4
Symptom reporting,
endoscopy,
oesophageal
manometry and pH
monitoring, barium
swallow
Need for PPI
Mejia-Rivas
36
GERD
et al.S1
et al.S2
et al.S3
et al.S4
et al.S6
et al.S7
et al.S8
et al.S9
Findings
Reduced (preoperative
87%, postoperative
22%)
Improvement in reflux,
worsening of dysphagia
Improvement in reflux;
no change in dysphagia
Reduced (preoperative
58%, postoperative
15%), no changes in
oesophageal
contractility
Reduced (preoperative
30%, postoperative
0%)
Reduced (preoperative
39%, postoperative
2%)
Decreased DeMeester
score, no oesophageal
dyskinesia, hypotonic
contraction
Reduced (preoperative
11%, postoperative
1.6%); hypotonic
contraction
Reduced (preoperative
64%, postoperative
33%)
Reduced (preoperative
17%, postoperative
0%)
Valezi
2012
81
High resolution
12
LES pressure
Increased LES
et al.11
manometry
hypotonia; increased
wave duration and
amplitude
Peterli
2013
Randomized
110
Symptom reporting
36
GERD
Reduced (preoperative
et al.S12
controlled
46%, postoperative
trial
13%)
Cassao
2013
Prospective
18
High resolution
36
Oesophageal
Increased LES
et al.S13
trial
manometry
sphincter
hypotonia, UES
pressures
hypertonia
Abbreviations: LES, lower oesophageal sphincter; PPI, proton pump inhibitors; UES, upper oesophageal sphincters.
et al.S10
Supplementary reference list
S1. Frezza, E. E. et al. Symptomatic improvement in gastroesophageal reflux disease (GERD) following laparoscopic Roux-en-Y
gastric bypass. Surg. Endosc. 16, 1027–1031 (2002).
S2. Clements, R. H. et al. Gastrointestinal symptoms are more intense in morbidly obese patients and are improved with
laparoscopic Roux-en-Y gastric bypass. Obes. Surg. 13, 610–614 (2003).
S3. Foster, A., Laws, H. L., Gonzalez, Q. H. & Clements, R. H. Gastrointestinal symptomatic outcome after laparoscopic Roux-en-Y
gastric bypass. J. Gastrointest. Surg. 7, 750–753 (2003).
S4. Ortega, J. et al. Outcome of esophageal function and 24-hour esophageal pH monitoring after vertical banded gastroplasty and
Roux-en-Y gastric bypass. Obes. Surg. 14, 1086–1094 (2004).
S5. Perry, Y. et al. Laparoscopic Roux-en-Y gastric bypass for recalcitrant gastroesophageal reflux disease in morbidly obese
patients. JSLS 8, 19–23 (2004).
S6. Nelson, L. G., Gonzalez, R., Haines, K., Gallagher, S. F. & Murr, M. M. Amelioration of gastroesophageal reflux symptoms
following Roux-en-Y gastric bypass for clinically significant obesity. Am. Surg. 71, 950–954 (2005).
S7. Merrouche, M. et al. Gastro-esophageal reflux and esophageal motility disorders in morbidly obese patients before and after
bariatric surgery. Obes. Surg. 17, 894–900 (2007).
1
S8. Mejia-Rivas, M. A., Herrera-Lopez, A., Hernandez-Calleros, J., Herrera, M. F. & Valdovinos, M. A. Gastroesophageal reflux disease
in morbid obesity: the effect of Roux-en-Y gastric bypass. Obes. Surg. 18, 1217–1224 (2008).
S9. Madalosso, C. A. et al. The impact of gastric bypass on gastroesophageal reflux disease in patients with morbid obesity: a
prospective study based on the Montreal Consensus. Ann. Surg. 251, 244–248 (2010).
S10.
Kehagias, I., Karamanakos, S. N., Argentou, M. & Kalfarentzos, F. Randomized clinical trial of laparoscopic Roux-en-Y
gastric bypass versus laparoscopic sleeve gastrectomy for the management of patients with BMI <50 kg/m2. Obes. Surg. 21,
1650–1656 (2011).
S11.
Valezi, A. C., Herbella, F. A., Junior, J. M. & de Almeida Menezes, M. Esophageal motility after laparoscopic Roux-en-Y
gastric bypass: the manometry should be preoperative examination routine? Obes. Surg. 22, 1050–1054 (2012).
S12.
Peterli, R. et al. Early results of the Swiss Multicentre Bypass or Sleeve Study (SM-BOSS): a prospective randomized trial
comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Ann. Surg. 258, 690–694 (2013).
S13.
Cassao, B. D., Herbella, F. A., Silva, L. C. & Vicentine, F. P. Esophageal motility after gastric bypass in Roux-en-Y for morbid
obesity: high resolution manometry findings. Arq. Bras. Cir. Dig. 26 Suppl 1, 22–25 (2013).
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