Study: Fondoplication, Roux-en-Y gastric bypass both viable for GERD patients with obesity

Editor's Note: 

Fondoplication and Roux-en-Y gastric bypass are both viable choices for treating gastroesophageal reflux disease (GERD) in patients with obesity, according to a recent study comparing the two procedures. Results were published December 27 in ScienceDirect.

The study was based on a retrospective review of a prospectively maintained quality database. It included patients with a body mass index ≥of 35 who presented for gastroesophageal reflux disease and subsequently underwent Roux-en-Y gastric bypass or fundoplication. Highlights include:

• Gastroesophageal reflux disease symptoms and overall quality of life improved for all patients.
• There were no significant differences in postoperative Reflux Symptom Index, Dysphagia, or Short-Form–36 scores.
• Significant differences in gastroesophageal reflux disease-Health Related Quality of Life scores were seen at preoperative, 1, 2, and 5 years postoperative (P < .05), with better symptom control in the fundoplication group.
• No significant difference was noted in postoperative DeMeester scores or percent time pH <4.
• Weight loss was significantly higher in the Roux-en-Y gastric bypass group at all postoperative time points up to 5 years (P < .05).

Researchers conclude that both choices are appropriate, despite previous data, and that choice of surgical approach should be directed to patient needs and desired goals at the time of the initial clinic visit.