Loop gastric bypass vs. Roux-en-Y gastric bypass: Assessment of reflux symptoms and quality of life after surgery

Abstract Introduction Obesity increases the risk of pelvic floor disorders in individuals with obesity, including faecal incontinence. Faecal incontinence (FI) is a condition with important clinical and psychosocial consequences. Though it is associated with obesity, the effect of bariatric surgery on the prevalence and severity of FI is not well reported. Objective To assess the effect of bariatric surgery on the prevalence and severity of FI in adult patients with obesity. Methods This systematic review was conducted in accordance with the PRISMA statement. Two independent reviewers performed a literature search in MEDLINE, PubMed, Cochrane and Embase from 1 January 1980 to 12 January 2019. We included published English-language randomized control trials and observational studies assessing pre- and post-bariatric surgery prevalence or severity of FI. Random-effects models with DerSimonian and Laird’s variance estimator were used for meta-analysis. Results Thirteen studies were included, eight assessing prevalence (678 patients) and 11 assessing severity of FI (992 patients). There was no significant difference in prevalence post-operatively overall, though it trended towards a reduction [pooled OR=0.55; =0.075]. There was a significant reduction of FI prevalence in women post-bariatric surgery [95% CI 0.22 to 0.94, p=0.034]. There was a statistically significant reduction in FI prevalence following Roux-en-Y gastric bypass and one anastomosis gastric bypass [0.46, 95% CI 0.26 to 0.81; p=0.007]. There was no significant reduction of incontinence episodes post-operatively [pooled mean difference =−0.17, 95% CI −0.90 to 0.56; p=0.65]. Quality of life (QOL) was not significantly improved post-bariatric surgery [mean differences for the following facets of QOL: behaviour −0.35, 95% CI −0.94 to 0.24; depression 0.04, 95% CI −0.12 to 0.2; lifestyle −0.33, 95% CI −0.98 to 0.33; p values of 0.25, 0.61 and 0.33, respectively]. Discussion There was a significant reduction in FI prevalence in women and those who underwent Roux-en-Y or one anastomosis gastric bypass. Our results for FI prevalence overall, FI severity and impact on quality of life were not statistically significant. Larger studies are needed in this under-researched area to determine the true effect of bariatric surgery on FI. Graphical abstract

Download Full-text

Single Anastomosis Duodenoileal Bypass or Roux-en-Y Gastric Bypass After Failed Sleeve Gastrectomy: Medium-Term Outcomes

Obesity Surgery ◽

10.1007/s11695-021-05609-1 ◽

2021 ◽

Author(s):

Phillip J. Dijkhorst ◽

May Al Nawas ◽

Laura Heusschen ◽

Eric J. Hazebroek ◽

Dingeman J. Swank ◽

...

Keyword(s):

Quality Of Life ◽

Weight Loss ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Revisional Surgery ◽

Complication Rates ◽

Total Weight Loss ◽

Micronutrient Deficiencies ◽

Single Anastomosis

Abstract Background Although the sleeve gastrectomy (SG) has good short-term results, it comes with a significant number of patients requiring revisional surgery because of insufficient weight loss or functional complications. Objective To investigate the effectiveness of the single anastomosis duodenoileal bypass (SADI-S) versus the Roux-en-Y gastric bypass (RYGB) on health outcomes in (morbidly) obese patients who had previously undergone SG, with up to 5 years of follow-up. Methods Data from patients who underwent revisional SADI-S or RYGB after SG were retrospectively compared on indication of surgery, weight loss, quality of life, micronutrient deficiencies, and complications. Results From 2007 to 2017, 141 patients received revisional laparoscopic surgery after SG in three specialized Dutch bariatric hospitals (SADI-S n=63, RYGB n=78). Percentage total weight loss following revisional surgery at 1, 2, 3, 4, and 5 years was 22%, 24%, 22%, 18%, and 15% for SADI-S and 10%, 9%, 7%, 8%, and 2% for RYGB (P<.05 for 1–4 years). Patients who underwent RYGB surgery for functional complications experienced no persistent symptoms of GERD or dysphagia in 88% of cases. No statistical difference was found in longitudinal analysis of change in quality of life scores or cross-sectional analysis of complication rates and micronutrient deficiencies. Conclusion Conversion of SG to SADI-S leads to significantly more total weight loss compared to RYGB surgery with no difference in quality of life scores, complication rates, or micronutrient deficiencies. When GERD in sleeve patients has to be resolved, RYGB provides adequate outcomes. Graphical abstract

Download Full-text

Evaluation of systemic conditions, tooth loss, body image, and quality of life of women with obesity and women who underwent gastric bypass surgery

Special Care in Dentistry ◽

10.1111/scd.12453 ◽

2020 ◽

Vol 40 (2) ◽

pp. 151-159

Author(s):

Gerson Aparecido Foratori‐Junior ◽

Leonardo Silva Máscoli ◽

Bruno Gualtieri Jesuino ◽

Alana Luiza Trenhago Missio ◽

Silvia Helena de Carvalho Sales‐Peres

Keyword(s):

Quality Of Life ◽

Body Image ◽

Gastric Bypass ◽

Tooth Loss ◽

Bypass Surgery ◽

Gastric Bypass Surgery

Download Full-text

Health-Related Quality-of-Life (HRQoL) on an Average of 12 Years After Gastric Bypass Surgery

Obesity Surgery ◽

10.1007/s11695-014-1513-6 ◽

2015 ◽

Vol 25 (7) ◽

pp. 1119-1127 ◽

Cited By ~ 29

Author(s):

Mustafa Raoof ◽

Ingmar Näslund ◽

Eva Rask ◽

Jan Karlsson ◽

Magnus Sundbom ◽

...

Keyword(s):

Quality Of Life ◽

Gastric Bypass ◽

Bypass Surgery ◽

Gastric Bypass Surgery ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Download Full-text

Quality of life after gastric bypass surgery: a cross-sectional study

International Journal of Medicine in Developing Countries ◽

10.24911/ijmdc.51-1609155060 ◽

2021 ◽

pp. 622-626

Author(s):

Reem Babqi ◽

Samaher Alotaibi ◽

Dina Binammar

Keyword(s):

Quality Of Life ◽

Gastric Bypass ◽

Bypass Surgery ◽

Gastric Bypass Surgery ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

Download Full-text

Long-Term Quality of Life Outcomes After Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass—a Comparative Study

Obesity Surgery ◽

10.1007/s11695-020-05049-3 ◽

2020 ◽

Author(s):

Cristina Fiorani ◽

Sophie R. Coles ◽

Myutan Kulendran ◽

Emma Rose McGlone ◽

Marcus Reddy ◽

...

Keyword(s):

Quality Of Life ◽

Bariatric Surgery ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Metabolic Effects ◽

Life Outcomes ◽

Post Bariatric Surgery ◽

Comorbidity Resolution

Abstract Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) have been shown to improve metabolic comorbidities as well as quality of life (QoL) in the obese population. The vast majority of previous studies have investigated the metabolic effects of bariatric surgery and there is a dearth of studies examining long-term QoL outcomes post bariatric surgery. The outcomes of 43 patients who underwent bariatric surgery were prospectively assessed, using BAROS questionnaires to quantify QoL and metabolic status pre-operatively, at 1 year and at 8 years. Total weight loss and comorbidity resolution were similar between RYGB and SG. The RYGB cohort experienced greater QoL improvement from baseline and had higher BAROS scores at 8 years. RYGB may provide more substantial and durable long-term benefits as compared to SG.

Download Full-text

Novel Reconstruction Using Roux-en-Y Plus Antral Obstruction Following Proximal Gastrectomy: Feasibility and Quality of Life Benefits

10.21203/rs.2.11422/v1 ◽

2019 ◽

Author(s):

Dejun Yang ◽

Changming Wang ◽

Hongbing Fu ◽

Ziran Wei ◽

Xin Zhang ◽

...

Keyword(s):

Quality Of Life ◽

Reflux Esophagitis ◽

Proximal Gastrectomy ◽

Partial Gastrectomy ◽

Incidence Rates ◽

Reconstruction Method ◽

Reflux Symptoms ◽

Reconstruction Methods ◽

Postoperative Reflux

Abstract Background and Aims Routine gastroesophagostomy has been shown to have adverse effects on the recovery of digestive functions and quality of life because patients typically experience reflux symptoms after proximal gastrectomy. This study was performed to assess the feasibility and quality of life benefits of a novel reconstruction method termed Roux-en-Y anastomosis plus antral obstruction (RYAO) following proximal partial gastrectomy. Methods A total of 73 patients who underwent proximal gastrectomy from June 2015 to June 2017 were divided into two groups according to digestive reconstruction methods [RYAO (37 patients) and conventional esophagogastric anastomosis with pyloroplasty (EGPP, 36 patients)]. Clinical data were compared between the two groups retrospectively. Results The mean operative time for digestive reconstruction was slightly longer in the RYAO group than in the EGPP group. However, the incidence of postoperative short-term complications did not differ between the RYAO and the EGPP groups. At the 6-month follow-up, the incidence rates of both reflux esophagitis and gastritis were lower in the RYAO group than in the EGPP group (P = 0.002). Additionally, body weight recovery was better in the RYAO group (P = 0.028). The scale tests indicated that compared with the patients in the EGPP group, the patients in the RYAO group had significantly reduced reflux, nausea and vomiting and reported improvements in their overall health status and quality of life (all P < 0.05). Conclusion RYAO reconstruction may be a feasible procedure to reduce postoperative reflux symptoms and the incidence of reflux esophagitis and gastritis, thus improving patient quality of life after proximal gastrectomy.

Download Full-text