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Master Thesis

Sleeve gastrectomie et œsophage de Barrett : résultats à long terme d’une étude multicentrique franco-italienne

Abstract : Background : Sleeve gastrectomy (SG) is currently the most performed bariatric procedure worldwide. Recent evidence has indicated an increased risk of Barrett’s esophagus in the long-term after the SG.
Aim : To investigate the prevalence of Barrett’s esophagus at histology, gastroesophageal reflux disease symptoms (GERD), and the use of PPI, in a series of patients issued from different bariatric centers with at least five years of follow-up after the SG.
Patients and methods : Five bariatric centers (three in France and two in Italy), who had had adopted the policy of offering a systematic endoscopy in search of Barrett’s esophagus confirmed at histology according to British Society of Gastroenterology guidelines, accepted to participate in the present study. Each investigating center was asked to enter information on at least 10 consecutives patients who had had the systematic endoscopy in their center in a standardized database.
Results : Exhaustive information was gathered on 90 consecutive patients from the five bariatric centers. There were 66 women and 24 men with a mean age of 41 (sd+/-11) years, a mean follow-up of 78 (sd +/-15) months and a mean total body weight loss was 33 % (sd+/- 19). The prevalence of Barrett’s esophagus at histology in the whole study population was 18,8 % with no significant difference among centers. Weight loss failure was significantly associated with Barrett’s esophagus (p<0.001). The prevalence of GERD symptoms, endoscopic lesions of esophagitis and the use of PPIs increased from 21%, 10% and 22% before the SG to 76%, 40% and 52 % at the time of follow-up respectively (p<0.05).
Conclusions : This study confirms that the SG results in a high rate of Barrett’s esophagus in the long-term and suggests the need to provide systematic endoscopy in these patients to rule out this condition.
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Master Thesis
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Lionel Sebastianelli. Sleeve gastrectomie et œsophage de Barrett : résultats à long terme d’une étude multicentrique franco-italienne. Médecine humaine et pathologie. 2018. ⟨dumas-02337867⟩

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