Esophageal Reflux Common After Sleeve Gastrectomy Esophageal Reflux Common After Sleeve Gastrectomy
About one in four patients will develop gastroesophageal reflux disease (GERD) after sleeve gastrectomy, but few will require conversion to gastric bypass for severe reflux, according to a systematic review and meta-analysis.Reuters Health Information
I would like to congratulate the authors on a very well written and well-designed study.i I believe the question that is being asked and subsequently answered in this paper is of paramount importance. Over the last several years there has been a paucity of data that is contradictory in the area of reflux after sleeve gastrectomy. However, in the most recent literature it would appear that the incidence of gastroesophageal reflux (GERD) is significant. A recent meta-analysis just released and ahead of print in the Annals of Surgery by Yeung et al, identified 46 studies with 10,000 plus patients and found an increase in post...
The development of gastroesophageal reflux disease (GERD) after laparoscopic sleeve gastrectomy (LSG) is a major concern as it affects the quality of life of the patients and potentially exposes them to the complications of GERD. The reported incidence of GERD after LSG is up to 35%. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is considered the procedure of choice for patients with morbid obesity with GERD but objective evidence based on physiologic studies for the same are limited.
The development of gastroesophageal reflux disease (GERD) after laparoscopic sleeve gastrectomy (LSG) is a major concern as it affects the quality of life of the patients and potentially exposes them to the complications of GERD. The reported incidence of GERD after LSG is up to 35%. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is considered the procedure of choice for patients with morbid obesity with GERD but objective evidence based on physiological studies for the same are limited.
ConclusionsLSG was found non-inferior to LRYGB with respect to weight loss and was associated with lower risk of major complications during a 3-year follow-up. But GERD increased in LSG group and decreased in LRYGB group.
ConclusionHiatal repair with gastropexy is an acceptable treatment option for GERD after LSG but not very effective because of partial remission of symptoms.
Alyce M. Martin1, Emily W. Sun1, Geraint B. Rogers2,3 and Damien J. Keating1,4* 1Molecular and Cellular Physiology Laboratory, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia 2Microbiome Research Laboratory, Flinders University, Adelaide, SA, Australia 3Infection and Immunity, South Australian Health and Medical Research Institute, Adelaide, SA, Australia 4Nutrition and Metabolism, South Australian Health and Medical Research Institute, Adelaide, SA, Australia The microbial community of the gut conveys significant benefits to host physiology. A clear relationship has now bee...
ConclusionThis study shows that the conversion of SG to OAGB is feasible and safe allowing significant weight loss and improvement in comorbidities. Weight loss seems comparable between the 150-cm and 200-cm BPL.
DR. JONATHAN MYERS (Chicago, Illinois): As the popularity of laparoscopic sleeve gastrectomy increases, the management of one of its known potential complications, gastro-esophageal reflux disease, remains a priority. To-date, medical management with medications such as PPIs or conversion to Roux-en-Y gastric bypass remain mainstays for those with severe symptoms. The authors are to be commended for exploring and offering a less invasive operative intervention for their patients who refused gastric bypass.
ConclusionThis study shows acceptable results with SG at 5 years in our unit, but a large number of patients experienced GORD and some patients needed additional micronutrient supplementation over and above our unit recommendation of a single multivitamin/mineral A–Z tablet daily.
Obesity is a risk factor for gastroesophageal reflux disease (GERD) , and esophageal acid exposure has been demonstrated to increase with the increase in body mass index (BMI) . It has been demonstrated that Roux-en-Y gastric bypass (RYGB) provides for a greater rate of GERD remission compared to sleeve gastrectomy (SG) and that SG may lead to significant rates of de novo GERD [4,5]. Thus, before deciding between SG and RYGB, patients should have screening and an evaluation for the presence GERD.