Our Summary

This study looked at 459 patients who had a type of weight loss surgery called sleeve gastrectomy (SG), where a large part of the stomach is removed, leaving a smaller tube-like section. The researchers wanted to see how often there were problems with this smaller stomach tube after surgery, and if these issues were linked to an increase in a condition called esophagitis, which is inflammation of the esophagus.

Of the patients, most were women, and the average age was 40.4 years. Before surgery, their average body mass index (BMI) was 39.70 kg/m2, which is considered very obese. After surgery, they found that around 1 in 5 patients had progression of esophagitis. Also, about 28.3% had an abnormality with their smaller stomach tube.

The most common issue was that the stomach tube became too wide (16.1% of patients), then it was that the stomach twisted (10.7%). Some patients developed a new upper part of their stomach (7.4%), and very few had a condition where the stomach pushes up into the chest (0.2%).

The researchers found that patients with any of these stomach tube issues were more likely to have esophagitis progression. However, when they looked at each issue separately, they didn’t find a significant link.

They concluded that problems with the smaller stomach tube aren’t uncommon after this type of surgery, and that these issues may contribute to some of the cases of esophagitis and acid reflux disease seen after the surgery.

FAQs

  1. What is the incidence of gastric tube abnormalities after sleeve gastrectomy (SG)?
  2. What is the relationship between gastric tube abnormalities and the progression of esophagitis?
  3. Are abnormalities of the gastric tube common after SG, and do they contribute to GERD and esophagitis?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastric sleeve surgery is to be aware of the possibility of gastric tube abnormalities, such as dilation, twist, neofundus, and hiatal hernia, which can contribute to the development or progression of esophagitis. It is important for patients to follow up with their healthcare provider regularly and report any symptoms of GERD or esophagitis, such as heartburn or difficulty swallowing, to address any potential issues early on.

Suitable For

Patients who are typically recommended for gastric sleeve surgery are those who have a body mass index (BMI) of 40 or higher, or a BMI of 35-39.9 with obesity-related health conditions such as diabetes, high blood pressure, or sleep apnea. Additionally, candidates for gastric sleeve surgery are typically those who have not been successful with other weight loss methods such as diet and exercise.

Timeline

Before gastric sleeve surgery:

  • Patient undergoes preoperative evaluations and consultations with healthcare providers to determine eligibility for surgery
  • Patient receives education on the procedure, risks, benefits, and postoperative lifestyle changes
  • Patient may be required to follow a specific preoperative diet or lose a certain amount of weight before surgery
  • Patient undergoes gastric sleeve surgery, which involves removing a portion of the stomach to create a smaller sleeve-shaped stomach pouch

After gastric sleeve surgery:

  • Patient is monitored closely in the immediate postoperative period for any complications
  • Patient follows a strict postoperative diet and lifestyle changes to aid in weight loss and prevent complications
  • Patient may experience changes in appetite, digestion, and food tolerance
  • Patient may experience improvements in obesity-related health conditions such as diabetes, hypertension, and sleep apnea
  • Patient undergoes follow-up appointments with healthcare providers to monitor progress and address any concerns or complications
  • Patient may experience weight loss and improved quality of life as a result of the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with gastric sleeve surgery, including gastric tube abnormalities?
  2. How common are gastric tube abnormalities after gastric sleeve surgery?
  3. How do gastric tube abnormalities contribute to the progression of esophagitis after surgery?
  4. What symptoms should I look out for that may indicate a gastric tube abnormality?
  5. How are gastric tube abnormalities diagnosed and treated?
  6. Are there any specific dietary or lifestyle recommendations to prevent or manage gastric tube abnormalities?
  7. What follow-up appointments or monitoring will be necessary to monitor for gastric tube abnormalities post-surgery?
  8. How does the presence of a gastric tube abnormality impact the long-term success of gastric sleeve surgery?
  9. Are there any specific factors that may increase my risk of developing gastric tube abnormalities after surgery?
  10. Are there any additional tests or screenings that should be considered to evaluate the health of my gastric tube post-surgery?

Reference

Authors: da Silva JD, Santa-Cruz F, Cavalcanti JMS, Padilha MV, Coutinho LR, Siqueira LT, Ferraz ÁAB. Journal: Obes Surg. 2023 Jan;33(1):263-267. doi: 10.1007/s11695-022-06375-4. Epub 2022 Dec 3. PMID: 36460942