Effects of Laparoscopic Sleeve Gastrectomy on Quality of Life Related to Gastroesophageal Reflux Disease
Journal of Laparoendoscopic&Advanced Surgical Techniques, Ahead of Print.
Conclusions: MSA is a safe, simple, and standardized antireflux procedure. It is also feasible in patients with refractory GERD following gastric/bariatric surgery. Further prospective and comparative studies are needed to validate the preliminary clinical experience in this subset of patients. PMID: 31624454 [PubMed - in process]
AbstractThe purpose of this study was to investigate the relationship between bariatric surgery (laparoscopic sleeve gastrectomy [LSG] and laparoscopic Roux-en-Y gastric bypass [LRYGB]) and gastroesophageal reflux disease (GERD). The number of obese patients with newly onset, worsened, or improved GERD after bariatric surgery in each article were extracted. In the pooled analysis, LSG was associated with a higher risk of GERD than LRYGB (odds ratio [OR] = 5.10, 95% confidence interval [CI] 3.60 –7.23,p
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 . 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 after LRYGB.
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).
ConclusionsPatients submitted to LSG showed a significant and progressive increase in the presence of “de novo” GERD. Also, an increased duodenogastric reflux was seen through an open and immobile pylorus. Therefore, based on these results, it seems like LSG is a “pro-reflux” surgical procedure, which should be continuously evaluated late after surgery.
Sleeve gastrectomy pouch imperfections have been implicated in postoperative gastroesophageal reflux disease (GERD) and other complications. Anatomy-based sleeve gastrectomy (ABS) has been developed to improve the shape, volume and anatomic consistency of the laparoscopic sleeve gastrectomy (LSG) pouch. In ABS, a pouch is created by applying a clamp 1-cm from the gastroesophageal junction, 3-cm from the incisura, 6-cm from the pylorus and stapling adjacent to the clamp.
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.
This study describes changes in GERD symptoms in patients undergoing LSG and HHR.
We report the short-term Results of our initial experience in LVGC.
Laparoscopic sleeve gastrectomy (LSG) is a commonly performed bariatric procedure in obesity management. Gastroesophageal reflux disease (GERD) in this population has reported rates of 23-100% GERD after LSG . GERD after LSG has been noted with recent studies demonstrating de novo reflux or symptom exacerbation despite weight loss. Fundoplication is not an option, and medically refractory GERD after LSG is usually treated with conversion to Roux-en-Y gastric bypass (RYGB). This video demonstrates the placement of a magnetic sphincter augmentation device after LSG as an alternative to conversion to RYGB.