Effect of Anti-reflux Suture on Gastroesophageal Reflux Symptoms After One Anastomosis Gastric Bypass: a Randomized Controlled Trial

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2024 Mar 19

PMID 38499781

Authors

Mohammad Kermansaravi

Masoumeh Shahsavan

Reza Ebrahimi

Ali Mousavimaleki

Barmak Gholizadeh

Rohollah Valizadeh

Shahab ShahabiShahmiri

Miguel A Carbajo

Affiliations

Soon will be listed here.

Abstract

Purpose: Gastroesophageal reflux disease (GERD) is an issue after one anastomosis gastric bypass (OAGB) and modification of OAGB with adding an anti-reflux system may decrease the incidence of postoperative GERD. This study aimed to compare the efficacy of the anti-reflux mechanism to treat preoperative GERD and prevent de novo GERD.

Methods: A prospective randomized clinical trial study was conducted on patients with a body mass index of 40 and more from August 2020 to February 2022. Patients undergoing one anastomosis gastric bypass with and without anti-reflux sutures (groups A and B, respectively). These patients had follow-ups for one year after the surgery. GERD symptoms were assessed in all the patients using the GERD symptom questionnaire.

Results: The mean age was 39.5 ± 9.8 years and 40.7 ± 10.2 years in groups A and B respectively. GERD symptoms remission occurred in 76.5% and 68.4% of patients in groups A and B, respectively. The incidence of de novo GERD symptoms was lower in group A, compared to group B (6.2% and 16.1% in groups A and B respectively), without any statistically significant difference (p-value: 0.239).

Conclusion: GERD symptoms and de novo GERD after OAGB seems to be under-reported after OAGB. This study suggests that applying an anti-reflux suture can decrease de novo GERD symptoms.

Citing Articles

ElFawal M, Taha O, Abdelaal M, Mohamad D, El Haj I, Tamim H Obes Surg. 2025; .

PMID: 40087244 DOI: 10.1007/s11695-025-07700-3.

Update on esophageal function, acid and non-acid reflux after one-anastomosis gastric bypass (OAGB): high-resolution manometry, impedance-24-h pH-metry, and gastroscopy in a prospective mid-term study.

Felsenreich D, Vock N, Zach M, Kristo I, Jedamzik J, Bichler C Surg Endosc. 2025; .

PMID: 39966130 DOI: 10.1007/s00464-025-11606-7.

Prevention of malnutrition after one anastomosis gastric bypass: value of the common channel limb length.

Mostafapour E, Shahsavan M, Shahmiri S, Jawhar N, Ghanem O, Kermansaravi M BMC Surg. 2024; 24(1):156.

PMID: 38755612 PMC: 11097460. DOI: 10.1186/s12893-024-02438-8.

References

Nam S, Choi I, Ryu K, Park B, Kim H, Nam B . Abdominal visceral adipose tissue volume is associated with increased risk of erosive esophagitis in men and women. Gastroenterology. 2010; 139(6):1902-1911.e2. DOI: 10.1053/j.gastro.2010.08.019. View

Kindel T, Oleynikov D . The Improvement of Gastroesophageal Reflux Disease and Barrett's after Bariatric Surgery. Obes Surg. 2016; 26(4):718-20. DOI: 10.1007/s11695-016-2116-1. View

Chiappetta S, Lainas P, Kassir R, Valizadeh R, Bosco A, Kermansaravi M . Gastroesophageal Reflux Disease as an Indication of Revisional Bariatric Surgery-Indication and Results-a Systematic Review and Metanalysis. Obes Surg. 2022; 32(9):3156-3171. DOI: 10.1007/s11695-022-06183-w. View

De Luca M, Piatto G, Merola G, Himpens J, Chevallier J, Carbajo M . IFSO Update Position Statement on One Anastomosis Gastric Bypass (OAGB). Obes Surg. 2021; 31(7):3251-3278. DOI: 10.1007/s11695-021-05413-x. View

Rutledge R . The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001; 11(3):276-80. DOI: 10.1381/096089201321336584. View

Mahawar K, Jennings N, Brown J, Gupta A, Balupuri S, Small P . "Mini" gastric bypass: systematic review of a controversial procedure. Obes Surg. 2013; 23(11):1890-8. DOI: 10.1007/s11695-013-1026-8. View

Carbajo M, Garcia-Caballero M, Toledano M, Osorio D, Garcia-Lanza C, Carmona J . One-anastomosis gastric bypass by laparoscopy: results of the first 209 patients. Obes Surg. 2005; 15(3):398-404. DOI: 10.1381/0960892053576677. View

Carbajo M, Luque-de-Leon E, Jimenez J, Ortiz-de-Solorzano J, Perez-Miranda M, Castro-Alija M . Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients. Obes Surg. 2016; 27(5):1153-1167. PMC: 5403902. DOI: 10.1007/s11695-016-2428-1. View

Seetharamaiah S, Tantia O, Goyal G, Chaudhuri T, Khanna S, Singh J . LSG vs OAGB-1 Year Follow-up Data-a Randomized Control Trial. Obes Surg. 2016; 27(4):948-954. DOI: 10.1007/s11695-016-2403-x. View

10.

Singh B, Saikaustubh Y, Singla V, Kumar A, Ahuja V, Gupta Y . One Anastomosis Gastric Bypass (OAGB) vs Roux en Y Gastric Bypass (RYGB) for Remission of T2DM in Patients with Morbid Obesity: a Randomized Controlled Trial. Obes Surg. 2023; 33(4):1218-1227. DOI: 10.1007/s11695-023-06515-4. View

11.

Kermansaravi M, Shahmiri S, Jazi A, Valizadeh R, Weiner R, Chiappetta S . Reversal to normal anatomy after one-anastomosis/mini gastric bypass, indications and results: a systematic review and meta-analysis. Surg Obes Relat Dis. 2021; 17(8):1489-1496. DOI: 10.1016/j.soard.2021.04.013. View

12.

Mahawar K, Himpens J, Shikora S, Chevallier J, Lakdawala M, De Luca M . The First Consensus Statement on One Anastomosis/Mini Gastric Bypass (OAGB/MGB) Using a Modified Delphi Approach. Obes Surg. 2017; 28(2):303-312. DOI: 10.1007/s11695-017-3070-2. View

13.

Gyawali C, Kahrilas P, Savarino E, Zerbib F, Mion F, Smout A . Modern diagnosis of GERD: the Lyon Consensus. Gut. 2018; 67(7):1351-1362. PMC: 6031267. DOI: 10.1136/gutjnl-2017-314722. View

14.

Schulz K, Altman D, Moher D . CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Int J Surg. 2011; 9(8):672-7. DOI: 10.1016/j.ijsu.2011.09.004. View

15.

Kermansaravi M, Mahawar K, Jazi A, Eghbali F, Kabir A, Pazouki A . Revisional surgery after one anastomosis/mini gastric bypass: A narrative review. J Res Med Sci. 2020; 25:62. PMC: 7554535. DOI: 10.4103/jrms.JRMS_727_19. View

16.

Franzen T, Tibbling L . Is the severity of gastroesophageal reflux dependent on hiatus hernia size?. World J Gastroenterol. 2014; 20(6):1582-4. PMC: 3925867. DOI: 10.3748/wjg.v20.i6.1582. View

17.

Jones R, Junghard O, Dent J, Vakil N, Halling K, Wernersson B . Development of the GerdQ, a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care. Aliment Pharmacol Ther. 2009; 30(10):1030-8. DOI: 10.1111/j.1365-2036.2009.04142.x. View

18.

Kermansaravi M, Kabir A, Mousavimaleki A, Pazouki A . Association between hiatal hernia and gastroesophageal reflux symptoms after one-anastomosis/mini gastric bypass. Surg Obes Relat Dis. 2020; 16(7):863-867. DOI: 10.1016/j.soard.2020.03.011. View

19.

Kermansaravi M, Shahmiri S, Khalaj A, Jalali S, Amini M, Malekpour Alamdari N . The First Web-Based Iranian National Obesity and Metabolic Surgery Database (INOSD). Obes Surg. 2022; 32(6):2083-2086. DOI: 10.1007/s11695-022-06014-y. View

20.

Chiappetta S, Stier C, Ghanem O, Abu Dayyeh B, Boskoski I, Prager G . Perioperative Interventions to Prevent Gastroesophageal Reflux Disease and Marginal Ulcers After Bariatric Surgery - an International Experts' Survey. Obes Surg. 2023; 33(5):1449-1462. DOI: 10.1007/s11695-023-06481-x. View