Gastrointestinal symptoms before and after laparoscopic Roux-en-Y gastric bypass: a longitudinal assessment
Gastrointestinal symptoms before and after laparoscopic Roux-en-Y gastric bypass: a longitudinal assessment
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DOI：
10.1016/j.soard.2019.03.018
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发表时间：
2019-06-01
影响因子：
3.1
通讯作者：
Gerdes, Victor E. A.
中科院分区：
文献类型：
--
作者：
Boerlage, Thomas C. C.;Westerink, Floris;Gerdes, Victor E. A.
背景：Roux-en-Y胃分流术(RYGB)是治疗病态肥胖的有效方法，但许多患者的胃肠道症状增加。目的：评估大量病态肥胖患者在RYGB手术前后的胃肠道症状和食物耐受性。背景：一家高容量减肥中心。方法：对2014年9月至2015年7月接受RYGB手术的患者进行前瞻性队列研究，并进行2年的随访。连续接受减肥手术的患者在RYGB前和手术后2年回答了胃肠道症状评定量表(GSRs)和食物不耐受问卷。比较两组患者手术前后胃肠道症状的发生率以及患者特征与术后胃肠道症状的关系。结果：初次RYGB组的随访率为86.2%(n=168)，复发组为93.3%(n=28)。手术后总平均GSRs评分从1.69增加到2.31(P<；.001)，16个单独评分中的13个也是如此。术前GSRS评分与术后症状严重程度相关(B=.343，P<；.001)。在原发RYGB前有16.1%的患者存在食物不耐受，术后增加到69.6%(P<；.001)。再次接受RYGB的患者的症状严重程度和食物不耐受的发生率与原发RYGB患者相当，尽管他们在再次手术前有更多的症状。结论：与术前相比，接受RYGB术后2年的患者胃肠道症状和食物不耐受的情况有所增加。重要的是，临床医生要意识到这一点，并在手术前告知患者。(C)2019年美国减肥外科学会。爱思唯尔公司出版，版权所有。
Background: Roux-en-Y gastric bypass (RYGB) is an effective treatment for morbid obesity, but many patients have increased gastrointestinal symptoms.Objectives: To evaluate gastrointestinal symptoms and food intolerance before and after RYGB over time in a large cohort of morbidly obese patients.Setting: A high-volume bariatric center of excellence.Methods: A prospective cohort study was performed in patients who underwent RYGB between September 2014 and July 2015, with 2-year follow-up. Consecutive patients screened for bariatric surgery answered the Gastrointestinal Symptom Rating Scale (GSRS) and a food intolerance questionnaire before RYGB and 2 years after surgery. The prevalence of gastrointestinal symptoms before and after surgery and the association between patient characteristics and postoperative gastrointestinal symptoms were assessed.Results: Follow-up was 86.2% (n = 168) for patients undergoing primary RYGB and 93.3% (n = 28) for revisional RYGB. The total mean GSRS score increased from 1.69 to 2.31 after surgery (P < .001), as did 13 of 16 of the individual scores. Preoperative GSRS score is associated with postoperative symptom severity (B =. 343, P < .001). Food intolerance was present in 16.1% of patients before primary RYGB, increasing to 69.6% after surgery (P < .001). Patients who underwent revisional RYGB had a symptom severity and prevalence of food intolerance comparable with that among patients with primary RYGB, even though they had more symptoms before revisional surgery.Conclusions: Two years after surgery, patients who underwent primary RYGB have increased gastrointestinal symptoms and food intolerance compared with the preoperative state. It is important that clinicians are aware of this and inform patients before surgery. (C) 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.