CLINICAL AND ENDOSCOPIC ANALYSIS OF GASTROESOPHAGEAL REFLUX DISEASE IN A PATIENT WHO UNDERWENT VERTICAL GASTRECTOMY

• DOI: https://doi.org/10.22533/at.ed.51572122610064

• Palavras-chave: Vertical gastrectomy; Gastroesophageal reflux disease; Obesity; Bariatric surgery; Upper gastrointestinal endoscopy.

• Keywords: Vertical gastrectomy; Gastroesophageal reflux disease; Obesity; Bariatric surgery; Upper gastrointestinal endoscopy.

• Abstract:

  Introduction: Vertical gastrectomy (VG) has established itself as one of the main surgical techniques for the treatment of obesity; however, its relationship with the onset or worsening of gastroesophageal reflux disease (GERD) remains controversial. Objective: To evaluate the prevalence and progression of GERD symptoms in obese patients who underwent laparoscopic VAG. Methods: A prospective longitudinal study involving 32 patients followed for 12 months, who underwent upper endoscopy (UE) and completed the GERD-Q questionnaire before and after surgery. Results: The mean age was 37 years and the mean BMI was 38.1 kg/m², with a predominance of females (93.8%). The percentage of weight loss was calculated based on the change in BMI and averaged 25.7% (p < 0.001).  Patients with lower GERD-Q scores had a greater mean BMI loss (27.4%). The reported prevalence of GERD fell from 15.6% to 4.5%, and the proportion of patients without endoscopic esophagitis increased from 71.9% to 78.1% after surgery. Notably, sleep quality improved as reflux scores decreased from 0.66 to 0.16 (p=0.032), an important factor in improving patients’ quality of life. There was no statistical association between reflux scores and clinical variables, the presence of Helicobacter pylori, or the degree of obesity. Conclusion: Vertical gastrectomy was effective in inducing significant weight loss at 12 months post-surgery. It was effective in improving sleep disturbance caused by GERD symptoms, with a lower GERDq score observed in patients who lost more weight (27.4%).  No trend toward worsening was observed in esophagitis, the GERDq score, or the reported reflux item. Therefore, vertical gastrectomy is considered an effective surgical procedure for the treatment of obesity without exacerbation or onset of symptoms or endoscopic changes indicative of gastroesophageal reflux disease.