Prevalence of dysphagia after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a national propensity score study.

Abstract

Background: The comparative incidence of dysphagia after laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) is not well-studied.

Objective: Examining the incidence and etiologies of dysphagia following LSG and RYGB in patients with obesity.

Setting: A national database TriNetX, which brings together data from 70 US-health care organizations, was utilized.

Methods: The incidence of dysphagia after RYGB and LSG versus patients with obesity who did not undergo bariatric surgery from 2014 to 2024. A 1:1 propensity score matching was performed to adjust for sleep apnea, proton pump inhibitor, reflux, age, tobacco, and alcohol abuse. The odds of developing dysphagia within 1 month, 1-3 months, 3-6 months, 6-12 months, 1-3 years, 3-5 years and 5-10 years after bariatric surgery was also examined. Patients with oropharyngeal dysphagia or those with dysphagia after a cerebrovascular incident were excluded from the study. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.

Results: 2,761,563 patients with obesity were included. 2,616,988 did not undergo surgery, 8.53% developed dysphagia. Twenty-nine thousand two hundred forty-twounderwent RYGB, 14.6% developed dysphagia (RYGB versus No Surgery OR = 2.48, 95% CI 2.24- 2.49). 57,013 patients underwent LSG, 8.67% developed dysphagia (LSG versus No surgery OR = 1.5; 95%CI 1.42-1.52). In both surgical groups, the incidence of dysphagia was highest within 30 days after the surgery. After matching RYGB (OR = 1.57; 95%CI 1.48-1.67) and LSG (OR = 1.16, 95%CI 1.10-1.12) remained independent risk factors for dysphagia.

Conclusion: The incidence of dysphagia is increased after both LSG and RYGB compared to patients with obesity who did not undergo surgery, though the increased incidence is more pronounced after RYGB.