Histological Esophagitis Before and After Surgical Treatment of Morbid Obesity (Capella Technique): A Prospective Study

• Published in: Obesity surgery 2008-04, Vol.18 (4), p.367-370
• Main Authors: Reis, Galzuinda Maria Figueiredo, Savassi-Rocha, Paulo Roberto, Nogueira, Ana Margarida M. F., Lima, Marcílio José Rodrigues, de Carvalho, Silas, Arantes, Vitor, Barros, Carlos Alberto, Cançado, Omar Lopes
• Format: Article
• Language: English
• Subjects: Adult; Body Mass Index; Esophagitis, Peptic - etiology; Esophagitis, Peptic - pathology; Esophagitis, Peptic - prevention & control; Female; Follow-Up Studies; Gastric Bypass; Gastroesophageal reflux; Gastrointestinal surgery; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Mucous Membrane - pathology; Obesity; Obesity, Morbid - complications; Obesity, Morbid - pathology; Obesity, Morbid - surgery; Prospective Studies; Research Article; Risk Factors; Surgery; Treatment Outcome; Weight Loss
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-008-9447-5

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.