Motilidade esofágica, sintomas, resultado alimentar e perda de peso após derivação gástrica em Y-de-Roux

BACKGROUND: Abnormal manometry findings can be found in the obese population. It is controversial if the manometry should be used to choose the adequate operation or if the motility status could predict symptomatic outcomes. AIM: To correlate the esophageal motility with postoperative symptoms, alimentary outcome and weight loss after Roux-en-Y gastric bypass. METHODS: One hundred and fourteen patients were submitted to the operation and were prospectively studied. They had no GERD symptoms or diseases that might interfere with esophageal motor function. One year after surgery patients were interviewed regarding current symptoms and eating habits. RESULTS: Excess weight loss was 66.2 %. Sixty (52.6%) patients had an abnormal manometry. Hypertensive lower esophageal sphincter was found in 18 (16%) patients and hypotonic sphincter in 31 (27%). Dumping syndrome was mentioned by 27 (23.6%) patients and 21 (18.4%) complained of regurgitation. Excellent, good, moderate and poor alimentary outcome was present in 32 (28%), 31 (27.2%), 39 (34.2%), 12 (11.6%) patients, respectively. Sphincter pressure and esophageal amplitude did not correlate with excess weight loss. Its average was significantly higher for patients with hypertensive esophageal amplitude. Regurgitation was more frequent in patients with a hypotensive sphincter. There is no correlation between dumping and sphincter pressure status; between dumping or regurgitation and esophageal amplitude; between alimentary outcomes and sphincter pressure status or esophageal amplitude. CONCLUSION: Esophageal manometry before Roux-en-Y gastric bypass is of limited clinical significance.