PMID- 29567054
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20191210
IS  - 1878-7533 (Electronic)
IS  - 1550-7289 (Linking)
VI  - 14
IP  - 5
DP  - 2018 May
TI  - Electrical stimulation of the lower esophageal sphincter to address 
      gastroesophageal reflux disease after sleeve gastrectomy.
PG  - 611-615
LID - S1550-7289(18)30085-6 [pii]
LID - 10.1016/j.soard.2018.02.006 [doi]
AB  - BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) can result in de novo and 
      worsen preexisting gastroesophageal reflux disease (GERD). Post-LSG patients with 
      GERD refractory to proton pump inhibitors (PPI) usually undergo more invasive, 
      anatomy-altering Roux-en-Y gastric bypass surgery. Lower esophageal sphincter 
      (LES) electrical stimulation (ES) preserves the anatomy and has been shown to 
      improve outcomes in GERD patients. OBJECTIVE: To evaluate the safety and efficacy 
      of LES-ES in post-LSG patients with GERD not controlled with maximal PPI therapy. 
      SETTING: Prospective, international, multicenter registry. METHODS: Patients with 
      LSG-associated GERD partially responsive to PPI underwent LES-ES. GERD outcomes 
      pre- and poststimulation were evaluated based on quality of life, esophageal acid 
      exposure (after 6-12 mo), and PPI use. RESULTS: Seventeen patients (11 female, 
      65%), treated at 6 centers between May 2014 and October, 2016 with a median 
      follow-up of 12 months (range 6-24), received LES-ES. Median age was 48.6 years 
      (interquartile range, 40.5-56), median body mass index 31.7 kg/m(2) (27.9-39.3). 
      All patients were on at least daily PPI preoperatively; at last follow-up, 7 
      (41%) were completely off PPI, 5 (29%) took PPI on an intermittent basis, and 5 
      (29%) were on single-dose PPI. Median GERD-health-related quality of life scores 
      improved from 34 (on-PPI, 25-41) at baseline to 9 (6-13) at last follow-up 
      (off-PPI, P<.001). Percentage of time with esophageal pH<4 improved from 13.2% 
      (3.7-30.7) to 5.8% (1.1-54.4), P = .01. CONCLUSION: LES-ES in post-LSG patients 
      suffering from symptomatic, PPI-refractory GERD resulted in significant 
      improvement of GERD-symptoms, esophageal acid exposure, and need for PPI. 
      Preserving the post-LSG anatomy, it offers a valid option for patients unable or 
      unwilling to undergo Roux-en-Y gastric bypass surgery.
CI  - Copyright (c) 2018 American Society for Bariatric Surgery. Published by Elsevier 
      Inc. All rights reserved.
FAU - Borbely, Yves
AU  - Borbely Y
AD  - Clinic for Visceral Surgery and Medicine, Inselspital, Bern University Hospital, 
      and University of Bern, Bern, Switzerland. Electronic address: 
      yves.borbely@insel.ch.
FAU - Bouvy, Nicole
AU  - Bouvy N
AD  - University of Maastricht, Maastricht, the Netherlands.
FAU - Schulz, Henning G
AU  - Schulz HG
AD  - Evangelisches Krankenhaus, Castrop-Rauxel, Germany.
FAU - Rodriguez, Leonardo Antonio
AU  - Rodriguez LA
AD  - Surgery, CCO Obesidad, Santiago, Chile.
FAU - Ortiz, Camilo
AU  - Ortiz C
AD  - Department of Surgery, Hospital El Tunal, Bogota, Colombia.
FAU - Nieponice, Alejandro
AU  - Nieponice A
AD  - Esophageal Surgery Program, University of Favaloro, Buones Aires, Argentina.
LA  - eng
PT  - Evaluation Study
PT  - Journal Article
PT  - Multicenter Study
DEP - 20180226
PL  - United States
TA  - Surg Obes Relat Dis
JT  - Surgery for obesity and related diseases : official journal of the American 
      Society for Bariatric Surgery
JID - 101233161
SB  - IM
MH  - Adult
MH  - Bariatric Surgery/*adverse effects
MH  - Electric Stimulation Therapy/*methods
MH  - *Esophageal Sphincter, Lower
MH  - Female
MH  - Gastrectomy/*adverse effects
MH  - Gastroesophageal Reflux/*therapy
MH  - Humans
MH  - Laparoscopy/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/surgery
MH  - Postgastrectomy Syndromes/etiology/therapy
MH  - Postoperative Complications/etiology/therapy
MH  - Prospective Studies
MH  - Quality of Life
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Bariatric surgery
OT  - Electric stimulation therapy
OT  - Esophageal pH
OT  - Gastroesophageal reflux
OT  - Lower esophageal sphincter
OT  - Postgastrectomy syndromes
OT  - Prospective studies
OT  - Proton Pump Inhibitors
OT  - Quality of life
OT  - Sleeve gastrectomy
EDAT- 2018/03/24 06:00
MHDA- 2018/12/12 06:00
CRDT- 2018/03/24 06:00
PHST- 2017/07/16 00:00 [received]
PHST- 2018/01/20 00:00 [revised]
PHST- 2018/02/03 00:00 [accepted]
PHST- 2018/03/24 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
PHST- 2018/03/24 06:00 [entrez]
AID - S1550-7289(18)30085-6 [pii]
AID - 10.1016/j.soard.2018.02.006 [doi]
PST - ppublish
SO  - Surg Obes Relat Dis. 2018 May;14(5):611-615. doi: 10.1016/j.soard.2018.02.006. 
      Epub 2018 Feb 26.