PREOPERATIVE MANOMETRY FOR THE SELECTION OF OBESE PEOPLE CANDIDATE TO SLEEVE GASTRECTOMY

Area of Science:

• Gastroenterology
• Surgical Innovation
• Esophageal Physiology

Background:

• Sleeve gastrectomy, a bariatric procedure, can impact esophageal motility and lower esophageal sphincter (LES) pressure.
• Understanding these potential postoperative changes is crucial for patient selection and management.

Purpose of the Study:

• To evaluate manometric changes in the esophagus and LES before and after sleeve gastrectomy.
• To identify patients at risk for developing postoperative esophageal motility disorders and LES pressure modifications.

Main Methods:

• Seventy-three patients underwent esophageal manometry preoperatively and one year postoperatively.
• Key variables analyzed included LES resting pressure, contraction wave amplitude and duration, and esophageal peristalsis.
• Data were compared pre- and post-surgery and to a healthy control group, with specific exclusion criteria applied.

Main Results:

• Preoperative manometric alterations were present in 49% of patients, including LES hypertonia (47%) and hypotonia (22%).
• One year post-surgery, 85% of patients showed altered manometry, with increased LES hypotonia (52%) and peristalsis changes (10%).
• Significant statistical differences were observed in LES pressure, contraction wave amplitude, and peristalsis between preoperative and postoperative periods.

Conclusions:

• Preoperative manometry is not effective in selecting candidates for sleeve gastrectomy based on potential esophageal functional changes.
• Postoperative esophageal and LES manometric alterations are common following sleeve gastrectomy.