August 20, 2020
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Barrett’s esophagus prevalence high after sleeve gastrectomy

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Patients who underwent esophagogastroduodenoscopy after sleeve gastrectomy experienced a high prevalence of Barrett’s esophagus, according to results published in Gastrointestinal Endoscopy.

“There was no correlation with [gastroesophageal reflux disease (GERD)] symptoms,” Bashar Qumseya, MD, MPH, associate professor in the division of gastroenterology, hepatology and nutrition at the University of Florida, and colleagues wrote. “Most cases were observed after 3 years of follow-up. Screening for [Barrett’s Esophagus] should be considered in patients after [sleeve gastrectomy] even in the absence of GERD symptoms postoperatively.”

During a 3-year period, Qumseya and colleagues conducted a search of search engines ending in July 2020. Their final analysis included 10 studies with 680 patients who had esophagogastroduodenoscopy after sleeve gastrectomy. Prevalence of Barrett’s esophagus in patients who underwent a sleeve gastrectomy served as the primary outcome. They evaluated heterogeneity with I2 and Q statistics and assessed publication bias with funnel plots and classic fail-safe.

Results showed a Barrett’s esophagus pooled prevalence of 11.6% (95% CI, 8.1-16.4%; I2 = 28.7%). Investigators did not observe a significant correlation between Barrett’s esophagus and prevalence of GERD with logistic meta-regression analysis ( = 3.5; 95% CI, –18 to 25p). They did see a linear relationship between the time of postoperative esophagogastroduodenoscopy and rate of esophagitis ( = 0.13; 95% CI, 0.06 – 0.2). After a sleeve gastrectomy, the risk for esophagitis increased by 13% each year.

“[T]he elevated risk of BE due to [sleeve gastrectomy] should be discussed with patients at the time of surgical referral,” the researchers wrote. “Patients at increased risk of BE should be given the option to have an alternative procedure.”