Importance of Esophageal pH monitoring and manometry in the preoperative evaluation for bariatric surgery to determine the surgical technique
DOI:
https://doi.org/10.33448/rsd-v15i3.50759Keywords:
Bariatric surgery, Gastroesophageal reflux disease, Esophageal pH monitoring, Esophageal manometry, Preoperative evaluation.Abstract
Obesity is a chronic disease with a high global prevalence and is frequently associated with Gastroesophageal Reflux Disease (GERD), a condition that may interfere with the outcomes of bariatric surgery. Therefore, adequate preoperative evaluation becomes essential for selecting the most appropriate surgical technique and preventing postoperative complications. This study aimed to evaluate the importance of esophageal pH monitoring and esophageal manometry in the preoperative evaluation of obese patients undergoing bariatric surgery, correlating body mass index (BMI), the DeMeester score, and the presence of gastroesophageal reflux symptoms. This is a retrospective cross-sectional observational study based on the analysis of secondary data obtained from medical records of patients who underwent bariatric surgery in a general surgery department in the city of Rio de Janeiro between 2015 and 2022. A total of 252 medical records were analyzed, considering variables such as sex, surgical technique, presence of reflux symptoms, and the results of esophageal pH monitoring and esophageal manometry. The results demonstrated a predominance of female patients and vertical sleeve gastrectomy as the most frequently performed surgical technique. A significant proportion of patients presented pathological acid reflux detected by pH monitoring, even in the absence of clinical symptoms, as well as esophageal motility disorders identified through manometry. It is concluded that esophageal pH monitoring and esophageal manometry are fundamental tools in the preoperative evaluation of bariatric surgery, contributing to the individualized selection of the surgical technique, reduction of GERD-related complications, and improvement of clinical outcomes and patients’ quality of life.
References
Ashrafi, D., Osland, E. & Memon, M. A. (2020). Bariatric surgery and gastroesophageal reflux disease. Annals of Translational Medicine. 8(supl. 1), S11. DOI: 10.21037/atm.2019.09.15.
Batista, A. O. & Dantas, R. O. (2022). Correlação entre sintomas e refluxo em pacientes com doença do refluxo gastroesofágico. Arquivos de Gastroenterologia. 59(2), 184–7.
Bou Daher, H. & Sharara, A. I. (2019). Gastroesophageal reflux disease, obesity and laparoscopic sleeve gastrectomy: the burning questions. World Journal of Gastroenterology. 25(33), 4805–13. DOI: 10.3748/wjg.v25.i33.4805.
Chang, P. & Friedenberg, F. (2014). Obesity and GERD. Gastroenterology Clinics of North America. 43(1), 161–73. DOI: 10.1016/j.gtc.2013.11.009.
Clarrett, D. M. & Hachem, C. (2018). Gastroesophageal reflux disease (GERD). Missouri Medicine. 115(3), 214–8.
Johnson, L. F. & Demeester, T. R. (1986). Development of the 24-hour intraesophageal pH monitoring composite scoring system. Journal of Clinical Gastroenterology. 8(supl. 1), 52–8. DOI: 10.1097/00004836-198606001-00008.
Lemme, E. M. O., Alvariz, A. C. & Pereira, G. L. C. (2021). Distúrbios funcionais esofágicos na avaliação pré-operatória de cirurgia bariátrica. Arquivos de Gastroenterologia. 58(2), 190–4.
Neto, R. M. L., Herbella, F. A. M., Schlottmann, F. & Patti, M. G. (2019). Does DeMeester score still define GERD? Diseases of the Esophagus. 32(5). DOI: 10.1093/dote/doy118.
Pereira et al. (2018). Metodologia da pesquisa científica. [Free ebook]. Editora da UFSM.
Risemberg, R. I. C., Wakin, M., & Shitsuka, R. (2026). A importância da metodologia científica no desenvolvimento de artigos científicos. E-Acadêmica, 7(1), e0171675. https://doi.org/10.52076/eacad-v7i1.675.
Shitsuka, R. et al. (2014). Matemática fundamental para tecnologia. (2ed). Editora Érica.
Vieira, S. (2021). Introdução à bioestatística. Rio de Janeiro. Editora GEN/Guanabara Koogan.
Wolfe, B. M., Kvach, E. & Eckel, R. H. (2016). Treatment of obesity: weight loss and bariatric surgery. Circulation Research. 118(11), 1844–55. DOI: 10.1161/CIRCRESAHA.116.307591.
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Copyright (c) 2026 Luis Arsenio Medina Sabando, Cindy Estephania Franco Cedeño, Gabrielle Vaz de Azevedo David, Frederico Japiassu Santiago, Guilherme Lemos Cotta Pereira
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