Gastroesophageal reflux disease and morbid obesity: To sleeve or not to sleeve?

In conclusion, the recent publication of pH monitoring data and the new insights in the association between sleeve morphology and GERD control have led to a wider acceptance of LSG as bariatric procedure also in obese patients with GERD, as recently stated in the 5(th) International Consensus Conference on sleeve gastrectomy. PMID: 28428706 [PubMed - in process]
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research

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Hiatal hernia repair is an essential step to reduce the incidence of gastroesophageal acid reflux disease in patients undergoing sleeve gastrectomy. The safety of addition, a hiatal hernia repair to sleeve gastrectomy, is a critical question.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Original article Source Type: research
Hiatal hernia repair is an essential step to reduce the incidence of gastroesophageal acid reflux disease in patients undergoing sleeve gastrectomy. The safety of addition, an hiatal hernia repair to sleeve gastrectomy, is a critical question.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Original articles Source Type: research
Gastroesophageal reflux disease (GERD) has a reported incidence of between 10% and 20% in Western populations with an even higher incidence in populations with obesity [1]. The vast majority of patients are managed medically with surgical intervention undertaken in those with recalcitrant GERD. Populations with obesity and recalcitrant GERD who are interested in weight loss surgery have historically undergone laparoscopic Roux-en-Y gastric bypass (LRYGB). De Goot et  al. [2], in their 2009 meta-analysis, demonstrated improvement in GERD in people with obesity after LRYGB.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Video case report Source Type: research
Gastroesophageal reflux disease (GERD) has a reported incidence of between 10 to 20% in western populations with an even higher incidence in populations with obesity (1). The vast majority of patients are managed medically with surgical intervention undertaken in those with recalcitrant GERD. Populations with obesity and recalcitrant GERD who are interested in weight loss surgery have historically undergone Laparoscopic Roux En Y Gastric Bypass (LRYGB). De Goot et al in their 2009 meta-analysis demonstrated improvement in GERD in people with obesity following LRYGB(2).
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
Hiatal hernia (HH) repair during laparoscopic sleeve gastrectomy (LSG) has been advocated to reduce postoperative gastroesophageal reflux disease (GERD) and/or intrathoracic migration (ITM) incidence. Previous,mid-term Results of a prospective, comparative study evaluating posterior cruroplasty concomitant with LSG (group A 48 patients with simple vs. group B 48 reinforced with bioabsorbable mesh) confirmed the safety and effectiveness of simultaneous procedures. Present aim: to report the 60 months follow-up update, evaluating GERD, esophageal lesions ’ incidence and HH’s recurrence.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
This study describes changes in GERD symptoms in patients undergoing LSG and HHR.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
The sleeve gastrectomy (SG) can be associated with postoperative gastroesophageal reflux (GERD) and when a hiatal hernia is present, it should be fixed. Earlier studies have shown that 20% of SG have a concomitant hiatal hernia repair (HHR) in a large clinical database (MBSAQIP). Administrative databases can also be used to examine this practice.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
Sleeve Gastrectomy alters the normal stomach anatomy resulting in a significant incidence of hiatal hernia and gastroesophageal reflux disease. Although many patients remain asymptomatic, many complain of severe reflux symptoms not responsive to medical management. To describe the diagnosis and treatment of hiatus hernia after sleeve gastrectomy with conversion to Omega Loop Bypass and using fixation suture technique.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
Sleeve gastrectomy (SG) patients often present with gastroesophageal reflux (GERD) symptoms postoperatively. Our aim was to evaluate factors that impact GERD recidivism or de novo after SG.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
Gastroesophageal reflux disease (GERD) is common in the morbidly obese population, and hiatal hernias are encountered in 20% to 52% of patients. Primary surgical repair of hiatal hernias, in particular the paraesophageal type, is associated with a higher recurrence rate in obese patients. Concomitant weight loss surgery may be advisable. Combined sleeve gastrectomy and paraesophageal hiatal hernia repair is feasible but can induce or worsen preexisting GERD. A Roux-en-Y gastric bypass offers advantages of more pronounced excess weight loss and better symptom control, albeit with a potentially higher rate of morbidity compa...
Source: Thoracic Surgery Clinics - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
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