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Background <p>GERD is a common comorbidity in patients with obesity, and its high incidence may be related to the increased intra-abdominal pressure caused by the accumulation of abdominal fat. Fundoplication is commonly used as a surgical procedure for treating GERD, but the recurrence rate of GERD is elevated in patients with obesity. RYGB is one of the most common metabolic bariatric surgeries which is safe and effective in patients with obesity.</p> Objectives <p>The aim of this study is to compare the effects and safety of RYGB and fundoplication in patients with obesity with GERD.</p> Methods <p>Systematic searches were conducted in databases such as PubMed, the Cochrane Library, Web of Science, EMBASE and Scopus for English-language studies comparing the therapeutic effects of RYGB and fundoplication in patients with GERD.</p> Results <p>Eleven studies involving 1,134 patients were included, with 485 (42.8%) in RYGB group and 649 (57.2%) in fundoplication (FUN) group. In the overall analysis and five subgroups (as primary surgery; as revisional surgery; without hiatal hernia repair; based on BMI and follow up duration), the results showed no significant differences for GERD symptom control between groups. In overall analysis, preoperative BMI and BMI reductions in the RYGB group were significantly higher, while FUN group had a higher preoperative HH rate. RYGB also resulted in a longer operation time, and higher complication rate in overall analysis. However, no differences in complication rate were observed during subgroup analyse.</p> Conclusions <p>Based on available data, our study indicated both RYGB and FUN appear to offer considerable improvement in GERD symptoms for patients with obesity and GERD. RYGB represents a viable consideration for these patients. However, the conclusion of GERD improvement is primarily based on patient-reported symptom improvement, and a critical limitation is the lack of objective GERD measures (e.g., pH monitoring) in the included studies. Furthermore, all included studies were observational, thus, future prospective trials are necessary to validate these findings.</p>

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Comparative Outcomes of Roux-en-Y Gastric Bypass and Fundoplication in Adults Living with Obesity and GERD: A Systematic Review and Meta-analysis

  • 期刊论文

  • 发表日期：

    2025年12月9日

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  • Ying Xing,
  • Wenmao Yan,
  • Rixing Bai

摘要

Background

GERD is a common comorbidity in patients with obesity, and its high incidence may be related to the increased intra-abdominal pressure caused by the accumulation of abdominal fat. Fundoplication is commonly used as a surgical procedure for treating GERD, but the recurrence rate of GERD is elevated in patients with obesity. RYGB is one of the most common metabolic bariatric surgeries which is safe and effective in patients with obesity.

Objectives

The aim of this study is to compare the effects and safety of RYGB and fundoplication in patients with obesity with GERD.

Methods

Systematic searches were conducted in databases such as PubMed, the Cochrane Library, Web of Science, EMBASE and Scopus for English-language studies comparing the therapeutic effects of RYGB and fundoplication in patients with GERD.

Results

Eleven studies involving 1,134 patients were included, with 485 (42.8%) in RYGB group and 649 (57.2%) in fundoplication (FUN) group. In the overall analysis and five subgroups (as primary surgery; as revisional surgery; without hiatal hernia repair; based on BMI and follow up duration), the results showed no significant differences for GERD symptom control between groups. In overall analysis, preoperative BMI and BMI reductions in the RYGB group were significantly higher, while FUN group had a higher preoperative HH rate. RYGB also resulted in a longer operation time, and higher complication rate in overall analysis. However, no differences in complication rate were observed during subgroup analyse.

Conclusions

Based on available data, our study indicated both RYGB and FUN appear to offer considerable improvement in GERD symptoms for patients with obesity and GERD. RYGB represents a viable consideration for these patients. However, the conclusion of GERD improvement is primarily based on patient-reported symptom improvement, and a critical limitation is the lack of objective GERD measures (e.g., pH monitoring) in the included studies. Furthermore, all included studies were observational, thus, future prospective trials are necessary to validate these findings.