Mini-gastric, Roux-en-Y bypass both reduce GERD symptoms at 1 year
Two bariatric procedures appeared equally effective in the treatment of morbid obesity and at reducing symptoms of GERD after one year of follow-up, according to research published in Bariatric Surgical Practice and Patient Care.
Mohamed Hassan Fahmy, MD, of the department of general surgery at Cairo University in Egypt, and colleagues wanted to compare Roux-en-Y gastric bypass (RYGB) with mini-gastric bypass (MGB) to determine if there was any difference in postoperative GERD, as well as the safety and efficacy of the two procedures.
“[MGB] appears to be an effective bariatric procedure that is safer and easier than the gold standard RYGB,” they wrote. “However, the procedure has been hindered in controversy especially regarding gastric or esophageal biliary reflux and long-term risk of gastric and esophageal cancers.”
In a prospective study, investigators randomly assigned 60 patients with morbid obesity to undergo either RYGB (n = 30) or MGB (n = 30). They recorded GERD symptoms using a score questionnaire and followed patients to assess for weight loss, GERD and biliary reflux, as well as condition of the stomach and esophagus.
Fahmy and colleagues found that the percentage of excess weight loss was slightly higher in the MGB group and recorded complications in 30% of the MGB compared with 40% in the RYGB group.
Although patients in the MGB group experienced exaggerated GERD symptoms after one month compared with the RYGB group (P = .008), symptoms improved significantly in both groups after 12 months.
Researchers detected biliary reflux in 11 patients in the MGB group (36.6%) but none in the RYGB group. Esophagitis was also more common in the MGB group (P = .008). Operation time was significantly longer in the RYGB group (P < .001).
Fahmy and colleagues wrote that their findings show that both procedures were effective, both in terms of weight loss and for the treatment of obesity-related metabolic complications.
“On short-term follow-up, MGB exaggerated GERD symptoms, but in the long run, symptoms decreased markedly,” they wrote. “MGB is a simpler and a shorter-duration procedure that has no disadvantage compared with RYGB at one year of follow-up.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.