Does digestive symptoms require esophago gastroscopy prior to bariatric procedure?


COD: 01_2018_05_2771 Categorie: ,

Serdar Yormaz, Kafali Yilmaz, Husnu Alptekin, Ilhan Ece, Fahrettin Acar, Bayram Çolak,
Mehmet Ertugrul Kafali, Enes Sahin, Mustafa Sahin

Ann Ital Chir, Digital Edition 2018, 7
Epub Ahead of Print – November 29

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AIM: Performance of routine preoperative esophagogastroduodenal endoscopy (EGE) in patients undergoing bariatric surgery
is still a controversial subject. The purpose of our study was to evaluate the benefits of performing preoperative EGE in
a cohort of bariatric patients.
MATERIAL AND METHODS: The present retrospective study was performed between March 2010 and June 2016. We
divided the study participants into two groups: group A comprised subjects without disturbing upper digestive signs, while
group B comprised patients with disturbing upper digestive signs. Logistic regression analysis was used to identify the predictors
that might be associated with abnormal outcomes.
RESULTS: Our study included 232 patients (who had undergone sleeve gastrectomy, gastric bypass, ileal interposition, or
transit bipartition). The average age was 41.4 ± 10.3 years, and the average body mass index (BMI) was 43.6 ± 5.1
kg/m2. Of all the observed gastroscopic abnormalities, the prevalence for gastritis (17.3%), followed by esophagitis
(10.2%), hiatus hernia (9.4%), and bulbitis (8.7%). In multivariate regression analysis, the Gastrointestinal Symptom
Rating Scale (GSRS) score and upper gastric symptoms were found to be the only independent predictive markers (OR
= 2.822, 95% CI: 1.674-3.456 and OR =2.735, 95% CI: 1.827-3.946, respectively). We identified a positive correlation
between abnormal EGE findings and postoperative complications.
CONCLUSION: Preoperative EGE had a high rate of detection for the possible abnormalities prior to bariatric surgery.
Upper gastric symptoms are significant predictive factors of postoperative complications. Performing preoperative EGE for
symptomatic patients could help reduce the morbidity and mortality rates in these patients.