Document Detail


Preoperative esophageal manometry and outcome of laparoscopic adjustable silicone gastric banding.
MedLine Citation:
PMID:  16858533     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Laparoscopic adjustable silicone gastric banding (LASGB) for morbid obesity has been reported to provide long-term weight loss with a low risk of operative complications. Nevertheless, esophageal dilation leading to achalasia-like and reflux symptoms is a feared complication of LASGB. This study evaluates the clinical benefit of routine preoperative esophageal manometry in predicting outcome after LASGB in morbidly obese patients. METHOD: A review of prospectively collected data on 77 patients who underwent routine esophageal manometry prior to LASGB for morbid obesity from February 2001 to September 2003 was performed. Aberrant motility, abnormal lower esophageal sphincter (LES) pressures, and other nonspecific esophageal motility disorders noted on preoperative esophageal manometry defined patients of the abnormal manometry group. Outcome differences in weight loss, emesis, band complications, and gastroesophageal reflux disease (GERD) resolution or improvement were compared between patients of the abnormal and normal manometry groups after LASGB. Analysis of variance (ANOVA) and chi-square tests were performed to determine the significance of these outcomes. RESULTS: Of the patients tested, 14 had abnormal esophageal manometry results, whereas 63 had normal manometry results before LASGB. There was no significant difference in percent excess weight loss (%EWL) at 6 and 12 months between the groups after gastric banding. Severe postoperative emesis occurred more frequently in patients with abnormal manometry results than in those with normal manometry results. There were two band-related complications, both of which occurred in patients of the normal manometry group. CONCLUSIONS: Preoperative esophageal manometry does not predict weight loss or GERD outcomes after LASGB in morbidly obese patients. Postoperative emesis was more common in patients with abnormal manometry findings, but such symptoms were manageable and did not lead to poor weight loss or to band removal or increased band-related complications.
Authors:
J I Lew; A Daud; M F DiGorgi; L Olivero-Rivera; D G Davis; M Bessler
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Publication Detail:
Type:  Journal Article     Date:  2006-07-20
Journal Detail:
Title:  Surgical endoscopy     Volume:  20     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-17     Completed Date:  2006-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1242-7     Citation Subset:  IM    
Affiliation:
Center for Obesity Surgery, New York-Presbyterian Hospital and Columbia University, College of Physicians and Surgeons, 161 Fort Washington Avenue, 6th Floor, Room 620, New York, New York 10032, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Esophagus / physiopathology*
Female
Gastroesophageal Reflux / etiology,  physiopathology
Gastroplasty / adverse effects,  instrumentation*
Humans
Laparoscopy* / adverse effects
Male
Manometry*
Middle Aged
Obesity, Morbid / complications,  physiopathology*,  surgery*
Predictive Value of Tests
Preoperative Care*
Prospective Studies
Silicones
Treatment Outcome
Vomiting / etiology
Chemical
Reg. No./Substance:
0/Silicones

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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