Histological esophagitis before and after surgical treatment of morbid obesity (Capella technique): a prospective study

Obes Surg. 2008 Apr;18(4):367-70. doi: 10.1007/s11695-008-9447-5. Epub 2008 Feb 22.

Abstract

Background: The effects of vertical banded gastroplasty/Roux-en-Y gastric bypass (Capella) on the esophageal mucosa of patients with histological esophagitis are poorly understood. To evaluate long-term effects, we investigated the persistence, aggravation or disappearance of histological esophagitis in patients with morbid obesity and reflux esophagitis (diagnosed by endoscopic biopsy) after Roux-en-Y gastric bypass.

Methods: Twenty-one patients with morbid obesity and esophagitis (histological diagnosis) were submitted to gastric bypass (Fobi-Capella technique) and underwent upper endoscopy and esophageal biopsy during the late postoperative period.

Results: The mean age of the patients was 42.57 +/- 7.49 years (30 to 56). Nineteen (90.48%) patients were women, and two (9.52%) were men. Before surgery, the patients presented a mean weight of 124.26 +/- 19.09 kg and a mean body mass index (BMI) of 48.46 +/- 6.37 kg/m(2). Thirteen (61.90%) patients had endoscopic esophagitis before surgery. The mean weight and BMI were 81.65 +/- 13.16 kg and 31.91 +/- 4.99 kg/m(2), respectively, during the late postoperative period (29.80 +/- 8.91 months). The mean percentage of excess weight loss was 68.7 +/- 14.6%. Among the 21 patients with a preoperative histological diagnosis of reflux esophagitis, five (23.18%) had the same diagnosis after surgery, and four (19.04%) continued to present findings of endoscopic esophagitis.

Conclusion: Vertical banded gastroplasty/Roux-en-Y gastric bypass (Capella technique) is effective in the treatment of reflux esophagitis. No association was observed between the percentage of excess weight loss and improvement of esophagitis.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Body Mass Index
  • Esophagitis, Peptic / etiology
  • Esophagitis, Peptic / pathology*
  • Esophagitis, Peptic / prevention & control
  • Female
  • Follow-Up Studies
  • Gastric Bypass*
  • Humans
  • Male
  • Middle Aged
  • Mucous Membrane / pathology
  • Obesity, Morbid / complications
  • Obesity, Morbid / pathology*
  • Obesity, Morbid / surgery*
  • Prospective Studies
  • Risk Factors
  • Treatment Outcome
  • Weight Loss