Page 54 - GALENIKA MEDICAL JOURNAL

i saradnika pokazano je da je došlo do histološke regresije Takođe, kod pacijenata kod kojih je nakon SG neophodna
BE godinu dana nakon RYGBP kod skoro 50% pacijenata . revizija zbog nekontrolisanih simptoma GERD, pojave BE ili
32
U ovoj studiji je u periodu praćenja od godinu dana verifiko- rezistentnog erozivnog ezofagitisa, RYGBP predstavlja pro-
vana i rezolucija refluksnog ezofagitisa kod svih pacijenata, ceduru izbora, sa rezolucijom refluksnih tegoba kod preko
sa rezolucijom simptoma GERD kod preko 90% bolesnika. 90% pacijenata.

Zaključak

Postoji jasna povezanost gojaznosti i gastroezofagealne refluksne bolesti, kako u pogledu učestalosti
simptoma GERD, tako i u pogledu prisustva hernije hijatusa jednjaka i komplikacija GERD. Iako
barijatrijska hirurgija ima odličan efekat na gubitak tjelesne težine i komorbiditete koji prate
gojaznost, procjena simptoma i komplikacija GERD je esencijalna prije izbora procedure. To naravno
podrazumijeva da je izvođenje endoskopije gornjeg digestivnog trakta apsolutno neophodno prije
barijatrijske hirurgije. Najčešća barijatrijska procedura, sleeve gastrektomija, nosi značajan rizik za
pogoršanje postojećeg ili nastanak de novo GERD. To se prevashodno odnosi na nedovoljno ispitane

pacijente i neadekvatno načinjenu hiruršku intervenciju. Sa druge strane, RYGBP ima povoljan efekat
na GERD, a ovu proceduru treba preporučiti pacijentima sa predoperativno verifikovanim GERD u
programu barijatrijske hirurgije. Takođe, RYGBP treba razmotriti kao primarni vid liječenja bolesnika
kod kojih je indikovana antirefluksna hirurgija, a imaju BMI preko 35 kg/m . RYGBP predstavlja i prvi
2
izbor za reviziju nakon SG zbog nekontrolisanih simptoma ili komplikacija GERD.

Abstract

The obesity pandemic is becoming one of the most significant global problems. Along with obesity, gastroesophageal reflux
disease (GERD) is becoming the most prevalent digestive problem. The relationship between these two conditions has been
proven - obesity directly affects the development of GERD, as well as an increase in the incidence of GERD complications. A
particular problem arises in patients who are candidates for bariatric surgery and have proven GERD, which can result in
postoperative reflux. The aim of this review is to highlight the interaction between these two conditions and present the
results of bariatric surgery in the context of evaluating reflux disease before and after the bariatric procedure.

Keywords: obesity, gastroesophageal reflux disease (GERD), bariatric surgery

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52 DOI: 10.5937/Galmed2306048S