A New Algorithm to Reduce the Incidence of Gastroesophageal Reflux Symptoms after Laparoscopic Sleeve Gastrectomy.

Ece, Ilhan; Yılmaz, Hüseyin; Acar, Fahrettin; Çolak, Bayram; Yormaz, Serdar; Şahi̇n, Mustafa

doi:10.1007/s11695-016-2518-0

Cited by 21 publications

(9 citation statements)

References 27 publications

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“…Data in literature regarding the relation between GERD and SG are still rather conflicting. Reflux symptoms after this procedure are reported to be improved in some studies [15,16] but worsened in others [17][18][19][20]. The socalled "antireflux barrier" is based on the correct disposition of several anatomic structures that compose it.…”

Section: Discussionmentioning

confidence: 99%

Sleeve gastrectomy and gastroesophageal reflux: a comprehensive endoscopic and pH-manometric prospective study

Castagneto-Gissey

Genco

Corpo

et al. 2020

Surgery for Obesity and Related Diseases

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Background: The impact of sleeve gastrectomy (SG) on gastroesophageal reflux disease (GERD) is still greatly debated. Most of the current evidence available is solely based on symptom evaluation or medication use, while a minority have implemented objective functional measurements. Objective: To better comprehend the pathophysiological mechanisms involved in the genesis of GERD after SG. Setting: University Hospital, Italy. Methods: A total of 21 patients affected by morbid obesity and eligible for SG were prospectively enrolled in the present study. Patients were evaluated by means of endoscopy, high-resolution manometry (HRM), 24-hour pH monitoring, and the Gastroesophageal Reflux Disease Health-Related Quality of Life questionnaire. Results: Follow-up was completed at least 1 year post operation (mean follow-up, 14.3 6 2.1 mo) by 19 patients. Body mass index decreased from 41.2 6 .9 to 26.8 6 .8 kg/m 2 (P , .001). Distal contractile integral significantly decreased from 2772.8 6 399.9 mm Hg/s/cm to 2060.4 6 338.9 mm Hg/ s/cm (P 5 .01). The 24-hour pH monitoring showed an overall reduction tendency of acid reflux, although this was not statistically significant. All analyzed endoscopic findings withstood substantial pejorative modifications after SG (P , .01). Distal contractile integral values at baseline predicted postoperative Z-line upward migration; HRM, distal latency, and DeMeester score at baseline predicted the development of erosive esophagitis at follow-up, by bootstrap estimates of a logistic regression. Conclusions: Postoperative GERD-related esophageal sequelae should be carefully considered after SG. Our results demonstrate how acid reflux does not seem to play a relevant role in the pathophysiology of post-SG GERD. Baseline HRM can help stratify the risk of developing erosive esophagitis and Z-line upward migration after SG, while postoperative endoscopic surveillance should be encouraged regardless of the presence or absence of symptoms. (Surg Obes Relat Dis 2020;-:1-9.

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Section: Discussionmentioning

confidence: 99%

Sleeve gastrectomy and gastroesophageal reflux: a comprehensive endoscopic and pH-manometric prospective study

Castagneto-Gissey

Genco

Corpo

et al. 2020

Surgery for Obesity and Related Diseases

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“…Techniques to prevent GORD post-LSG include excluding patients with severe GORD, preserving the incisura angle and the phreno-oesophageal ligaments and repairing any hiatal herniae. [28] However, there is no general consensus. [9] Both our patients who had a hiatal hernia repair did not develop symptomatic GORD; this is in keeping with a recently published study.…”

Section: Discussionmentioning

confidence: 99%

A prospective study of gastro-oesophageal reflux disease symptoms and quality of life 1-year post-laparoscopic sleeve gastrectomy

et al. 2019

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“…Но, вместе с тем, публикуется все больше данных разных авторов по отдаленным результатам, которые выявляют очевидные принципиальные недостатки слив-резекции, связанные с высокой частотой рецидива ожирения [141], и осложнениями, вызванными высоким внутрижелудочным давлением, обусловленным сохранением пилорического жома. Доказано, что функционирование пилорического жома, которое, очевидно казавшееся ранее как важное достоинство продольной рукавной резекции желудка и позволявшее говорить о достаточной физиологичности операции, является причиной несостоятельности швов и вновь развивающегося рефлюкс-эзофагита [142,143].…”

Section: заключениеunclassified

Концепция Бесстеплерного Гастрошунтирования

Оспанов¹,

Нао²,

Астана³

2019

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Баймаханов Болатбек Бимендеевич, доктор медицинских наук, профессор медицины, председатель Правления АО "Национальный научный центр хирургии" им. А.Н. Сызганова, член-корреспондент Национальной Академии наук Республики Казахстан, академик Российской Академии медицинских наук, член Всемирной Ассоциации хирургов-гепатологов, вице-президент Ассоциации гепатопанкреатобилиарных хирургов стран СНГ, г. Алматы, Казахстан. Ержанов Омаркан Нурканович, доктор медицинских наук, профессор медицины, профессор кафедры хирургических болезней Карагандинского государственного медицинского университета, действительный член Всемирной федерации хирургии ожирения и метаболических нарушений (IFSO), г. Караганда, Казахстан.

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A New Algorithm to Reduce the Incidence of Gastroesophageal Reflux Symptoms after Laparoscopic Sleeve Gastrectomy.

Abstract: This study confirm that careful attention to patient selection and surgical technique can reduce the symptoms of GERD at short-term. Routine bilateral crus exploration could be a major risk factor of postoperative GERD.

Cited by 21 publications

References 27 publications

Sleeve gastrectomy and gastroesophageal reflux: a comprehensive endoscopic and pH-manometric prospective study

Sleeve gastrectomy and gastroesophageal reflux: a comprehensive endoscopic and pH-manometric prospective study

A prospective study of gastro-oesophageal reflux disease symptoms and quality of life 1-year post-laparoscopic sleeve gastrectomy

Концепция Бесстеплерного Гастрошунтирования

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