The effect of laparoscopic sleeve gastrectomy with or without hiatal hernia repair on gastroesophageal reflux disease in obese patients

Santonicola, Antonella; Angrisani, Luigi; Cutolo, Pierpaolo; Formisano, Giampaolo; Iovino, Paola

doi:10.1016/j.soard.2013.09.006

Cited by 111 publications

(65 citation statements)

References 28 publications

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“…The data analysis demonstrated that LSG has a beneficial effect on relieving GERD symptoms, although the underlying mechanisms are still unclear. Conversely, the HH repair did not induce any improvement in GERD symptoms [20]. These findings are in contrast with all of the previous reports that recommended the repair of hiatal defect as a method to prevent/reduce de novo GERD, indicating that detailed knowledge is scanty and this topic remains controversial.…”

Section: Hiatus Hernia Repair During Laparoscopic Sleeve Gastrectomycontrasting

confidence: 82%

“…The diagnosis of HH is based on indirect techniques as the doublecontrast barium swallow, the upper gastrointestinal endoscopy, and the esophageal manometry, which do not allow the direct assessment of the gastroesophageal junction. This area is also easily disclosed intra-operatively during upper abdominal surgery procedures [20]. Many surgeons will simultaneously perform the laparoscopic sleeve gastrectomy (LSG) and restore the stretched hiatus by hiatoplasty in case that HH is diagnosed pre-or intra-operatively [21].…”

Section: Gerd After Sleeve Gastrectomymentioning

confidence: 99%

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Gastroesophageal Reflux Disease and Sleeve Gastrectomy

et al. 2015

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Gastroesophageal reflux disease (GERD) and/or hiatus hernia (HH) are one of the most common disorders of the upper gastrointestinal tract. Despite the positive effect of sleeve gastrectomy (SG) regarding weight loss and improvement in obesity co-morbidities, there are concerns about the development of de novo gastroesophageal reflux disease or worsening the existing GERD after this bariatric operation. Furthermore, controversy exists on the consequences of SG in lower esophageal sphincter function and about the ideal procedure when a hiatus hernia is preoperatively diagnosed or discovered during the laparoscopic SG. This review systematically investigates the incidence, the pathophysiology of GERD and/or HH in morbidly obese individuals before and after SG, and the treatment options for concomitant HH repair during laparoscopic sleeve gastrectomy.

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Section: Hiatus Hernia Repair During Laparoscopic Sleeve Gastrectomycontrasting

confidence: 82%

Section: Gerd After Sleeve Gastrectomymentioning

confidence: 99%

Gastroesophageal Reflux Disease and Sleeve Gastrectomy

et al. 2015

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“…We believe that HHR may modify the normal anatomic and physiologic antireflux mechanisms as well as properties of the LES in a way that may contribute to reflux after LSG. Our findings echo recently reported results by Iovino et al, which demonstrated that patients who underwent LSG with HHR did not show any improvement in the prevalence and intensity-frequency scores of typical GERD symptoms and had significantly higher heartburn frequency-intensity scores than patients who underwent LSG alone [30]. The utility of concomitant HHR along with bariatric procedures has been questioned in other settings too, including adjustable gastric banding.…”

Section: Discussionsupporting

confidence: 85%

The Effect of Laparoscopic Sleeve Gastrectomy with Concomitant Hiatal Hernia Repair on Gastroesophageal Reflux Disease in the Morbidly Obese

et al. 2015

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Based on our data, LSG with concomitant HHR improved GERD symptoms or the need for daily antisecretory therapy only in a third of symptomatic patients. Furthermore, 15.6 % of asymptomatic patients developed de novo GERD symptoms despite a HHR. In patients with a documented hiatal hernia, HHR does not lead to GERD resolution or prevention after LSG, indicating the need for appropriate patient counseling and further study.

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“…More evidence now exists on the misdiagnosis and under-treatment of small and often asymptomatic pre-LSG hiatal hernias (27). As part of consensus criteria, these hiatal hernias are more aggressively sought after and treated (27). treatment of the GErd cases refractory to medical therapy is usually conversion to rYGB.…”

Section: Resultsmentioning

confidence: 99%

Changing Trends in Bariatric Surgery

2014

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Background and Aims: Bariatric surgery is considered the only long-lasting treatment for morbid obesity. Techniques and procedures have changed dramatically. We report on some of the major changes in the field. Materials and Methods: We reviewed some of the major changes in trends in bariatric surgery based on some landmark paper published in the literature. Results: We identified three major phases in the evolution of bariatric surgery. The pioneer phase was mostly characterized by discovery of weight loss procedures serendipitously from procedures done for other purposes. The second phase can be identified with the advent of laparoscopic techniques. This is considered the phase of greatest expansion of bariatric surgery. The metabolic phase derives from the improved understanding of the mechanisms of actions of the bariatric operations at the hormonal and molecular level. Conclusions: Bariatric surgery has changed significantly over the years. The safety of the laparoscopic approach, along with the better understanding of the metabolic changes obtained postoperatively, has led to a more individualized approach and also an attempt to expand the indications for these procedures.

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The effect of laparoscopic sleeve gastrectomy with or without hiatal hernia repair on gastroesophageal reflux disease in obese patients

Cited by 111 publications

References 28 publications

Gastroesophageal Reflux Disease and Sleeve Gastrectomy

Gastroesophageal Reflux Disease and Sleeve Gastrectomy

The Effect of Laparoscopic Sleeve Gastrectomy with Concomitant Hiatal Hernia Repair on Gastroesophageal Reflux Disease in the Morbidly Obese

Changing Trends in Bariatric Surgery

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