PMID- 29799107
OWN - NLM
STAT- MEDLINE
DCOM- 20191016
LR  - 20191016
IS  - 1708-0428 (Electronic)
IS  - 0960-8923 (Linking)
VI  - 28
IP  - 10
DP  - 2018 Oct
TI  - Characterization of Self-Reported Dysphagia and Impact on Weight Outcomes After 
      Laparoscopic Sleeve Gastrectomy.
PG  - 3177-3185
LID - 10.1007/s11695-018-3293-x [doi]
AB  - INTRODUCTION/AIMS: There is paucity of literature examining dysphagia after 
      laparoscopic sleeve gastrectomy (LSG). Moreover, there are few validated scoring 
      systems for dysphagia that adequately assess its psychosocial impact. We aim to 
      investigate dysphagia after LSG using a multidimensional scale that examines its 
      functional and emotional impact. As secondary aims, we evaluated the impact of 
      dysphagia on weight outcomes and its relationship with pre-operative 
      gastro-esophageal reflux disease (GERD) and proton pump inhibitor (PPI) use. 
      METHODS: One hundred twenty-four patients 1 year or more post-LSG were 
      administered the validated Dysphagia Handicap Index (DHI) questionnaire. To 
      further delineate esophageal dysphagia, three additional questions were added. 
      One hundred one patients (81.5%) responded. Physical, Emotional, Functional, and 
      Esophageal scales were analyzed combined and individually using a multivariate 
      model. RESULTS: No patients reported dysphagia pre-operatively. The median DHI 
      scale scores are the following: Physical-2 (0-20); Functional-4 (0-22); 
      Emotional-2 (0-14); and Esophageal-2 (0-8). On multivariate analysis, DHI 
      Emotional scores significantly correlated with reduced total weight loss (%TWL) 
      (p = 0.001) and excess weight loss (%EWL) (p = 0.023). The physical symptoms of 
      dysphagia did not affect weight outcomes. Post-operatively, PPI usage increased 
      significantly (15.8 vs 19.8%, p = 0.01) and correlated with higher dysphagia 
      scores. CONCLUSION: A statistically validated dysphagia-specific questionnaire 
      was utilized to evaluate the impact of LSG on dysphagia including its functional 
      and emotional influences. The psychosocial handicap of dysphagia significantly 
      reduced weight loss outcomes. A correlation between PPI use and dysphagia after 
      LSG was found. The prevalence of dysphagia after LSG and the factors that 
      contribute to its symptoms need to be further studied.
FAU - Jaffar, Sukaina
AU  - Jaffar S
AUID- ORCID: 0000-0002-5421-8430
AD  - Department of Upper Gastrointestinal Surgery and General Surgery, Nepean 
      Hospital, Nepean Blue Mountains Local Health District, Sydney, NSW, Australia. 
      Jaffar.su@gmail.com.
FAU - Devadas, Michael
AU  - Devadas M
AD  - Department of Upper Gastrointestinal Surgery and General Surgery, Nepean 
      Hospital, Nepean Blue Mountains Local Health District, Sydney, NSW, Australia.
AD  - Department of Bariatric Surgery and Upper Gastrointestinal Surgery, Blacktown 
      Hospital, Western Sydney Local Health District, Sydney, NSW, Australia.
AD  - Centre for Bariatric and Metabolic Surgery, Circle of Care - Institute of Weight 
      Control, Hospital for Specialist Surgery, Sydney, NSW, Australia.
AD  - Department of Upper Gastrointestinal Surgery and General Surgery, Nepean Private 
      Hospital, Sydney, NSW, Australia.
AD  - Department of Upper Gastrointestinal Surgery and General Surgery, Norwest Private 
      Hospital, Sydney, NSW, Australia.
AD  - Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Obes Surg
JT  - Obesity surgery
JID - 9106714
SB  - IM
MH  - Cohort Studies
MH  - *Deglutition Disorders/epidemiology/psychology
MH  - *Gastrectomy
MH  - Humans
MH  - *Laparoscopy
MH  - *Obesity, Morbid/epidemiology/surgery
MH  - *Postoperative Complications/epidemiology/psychology
MH  - Self Report
MH  - Weight Loss/physiology
OTO - NOTNLM
OT  - Bariatric surgery
OT  - Dysphagia
OT  - Dysphagia handicap index
OT  - Quality of life (QoL)
OT  - Sleeve gastrectomy
EDAT- 2018/05/26 06:00
MHDA- 2019/10/17 06:00
CRDT- 2018/05/26 06:00
PHST- 2018/05/26 06:00 [pubmed]
PHST- 2019/10/17 06:00 [medline]
PHST- 2018/05/26 06:00 [entrez]
AID - 10.1007/s11695-018-3293-x [pii]
AID - 10.1007/s11695-018-3293-x [doi]
PST - ppublish
SO  - Obes Surg. 2018 Oct;28(10):3177-3185. doi: 10.1007/s11695-018-3293-x.