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.... Istituzione Italian Group For Lap-Band and BIB (GILB): comprendente 20 centri italiani di chirurgia bariatrica: TO, MI. (3), VC, FI, BO, TR, RM (2), NA(3) CH, PE, RC, SA, CT, PA. Posizione Coordinatore Nazionale.
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Alfredo GENCO | Cited by 2,372 | of Sapienza University of Rome, Rome (la sapienza) | Read 106 publications | Contact Alfredo GENCO
- Introduction
- Methods
- Results
- Discussion
- Funding
- Acknowledgements
The prevalence of gastro-oesophageal reflux disease (GORD) is known to be substantially greater in people with overweight or obesity compared with the general population1. This seems to be a consequence of increased intra-abdominal pressure caused by excess visceral adiposity, in turn leading to decreased lower oesophageal sphincter competence, oft...
Study design
This was a prospective multicentre study designed to evaluate the long-term effects of bariatric surgery on GORD. The study flow chart is depicted in Fig. 1. Between October 2006 and December 2010, a total of 373 patients with morbid obesity underwent bariatric surgery at Sapienza University Hospital in Rome, Italy. One-hundred and fifteen patients received AGB, 162 SG, and 96 RYGB. Endoscopic follow-up was routinely performed 2 years after bariatric surgery, and surveillance was continued ev...
Sample size calculation
The authors hypothesized that SG resulted in a higher prevalence of oesophagitis in the mid to long term, compared with AGB, RYGB, and OAGB. The primary endpoint was the difference in incidence of GORD and its related esophageal modifications among patients who underwent AGB, RYGB, or OAGB, compared with those who received SG. The study was powered to detect an absolute difference of 20 percentage points in the incidence of oesophagitis between the AGB and SG group (on the basis of an inciden...
Postoperative follow-up
Following completion of all surgical procedures, an upper gastrointestinal series with a water-soluble iodinated contrast was routinely performed 1–2 days postoperatively. Patients were discharged on a semiliquid diet for 1 month, as well as with 30 mg daily of PPIs for the first 3 months, followed by 15 mg for the next 2 months, and thereafter discontinued if the patient was asymptomatic for GORD. Follow-up comprised medical examination at 1, 3, 6, and 12 months after surgery and once a year...
Between October 2006 and December 2010, a total of 498 patients underwent the following bariatric surgical procedures: AGB, 117 patients; RYGB, 100 patients; SG, 165 patients. Between January 2015 and December 2018, 116 patients underwent OAGB. Of these, 14 subjects (2.8 per cent) were excluded from the study due to early-onset postoperative compli...
Outcomes emerging from the present study underline how SG exposes the patient to risk of GORD and associated oesophageal mucosal lesions. Specifically, GORD symptoms significantly increased following SG and AGB, whereas there was only a slight, but not significant rise in patients who had OAGB. By contrast, RYGB was the only procedure that resulted...
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
The authors thank Professor Basso who was one of the pioneers of bariatric/metabolic surgery and started a bariatric programme at their institution in the early 2000s. Disclosure. The authors declare no conflict of interest.
Background: Morbidly obese patients are affected by gastroesophageal reflux disease (GERD) and hiatal hernia (HH) more frequently than lean patients. Because of conflicting results, the indication to sleeve gastrectomy (SG) in patients with GERD is still debated.
- Alfredo Genco, Emanuele Soricelli, Giovanni Casella, Roberta Maselli, Lidia Castagneto-Gissey, Nicol...
- 2017
Apr 1, 2017 · Dr. Alfredo Genco reports that he is Consultant/Trainer of Apollo Endosurgery, Inc., Austin, Texas, since January 2015. The other authors have no commercial associations that might be a conflict of interest in relation to this article.
- Alfredo Genco, Emanuele Soricelli, Giovanni Casella, Roberta Maselli, Lidia Castagneto-Gissey, Nicol...
- 2017
Background: Sleeve gastrectomy (SG) leads to esophageal mucosal damage in an elevated percentage of cases, configuring a clinical condition of Barrett's esophagus (BE) in a proportion as high as 15-18.8%. BE may rarely evolve into esophageal adenocarcinoma (EAC).
Abstract. First identified as a feasible treatment for intractable epilepsy, the ketogenic diet (KD) has recently gained popularity thanks to growing evidence on applications such as weight loss, most importantly, but also NAFLD, cancer, neurologic conditions and chronic pain.
