Sleeve gastrectomy and anti-reflux procedures
| Autor: | Daniel Lomelin, Crystal Krause, Christopher Crawford, Kyle Gibbens, Dmitry Oleynikov, Anton Simorov |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Reoperation
medicine.medical_specialty Sleeve gastrectomy Gastroplasty Radiofrequency ablation medicine.medical_treatment Gastric Bypass Bariatric Surgery Fundoplication 030209 endocrinology & metabolism Catheter ablation Esophageal Sphincter Lower law.invention 03 medical and health sciences 0302 clinical medicine law Gastrectomy medicine Humans Biliopancreatic Diversion Herniorrhaphy business.industry General surgery digestive oral and skin physiology Reflux digestive system diseases Surgery Obesity Morbid medicine.anatomical_structure Hernia Hiatal Catheter Ablation Gastroesophageal Reflux Magnets Sphincter 030211 gastroenterology & hepatology business Abdominal surgery |
| Zdroj: | Surgical endoscopy. 31(3) |
| ISSN: | 1432-2218 |
| Popis: | Obesity is an epidemic in the USA that continues to grow, becoming a leading cause of premature avoidable death. Bariatric surgery has become an effective solution for obesity and its comorbidities, and one of the most commonly utilized procedures, the sleeve gastrectomy, can lead to an increase in gastroesophageal reflux following the operation. While these data are controversial, sometimes operative intervention can be necessary to provide durable relief for this problem. We performed an extensive literature review examining the different methods of anti-reflux procedures that are available both before and after a sleeve gastrectomy. We reviewed several different types of anti-reflux procedures, including those that supplement the lower esophageal sphincter anatomy, such as magnetic sphincter augmentation and radiofrequency ablation procedures. Re-operation was also discussed as a possible treatment of reflux in sleeve gastrectomy, especially if the original sleeve becomes dilated or if a conversion to a Roux-en-Y gastric bypass or biliopancreatic diversion is deemed necessary. Sleeve gastrectomy with concomitant anti-reflux procedure was also reviewed, including the anti-reflux gastroplasty, hiatal hernia repair, and limited fundoplication. A number of techniques can be used to mitigate the severity of reflux, either by maintaining the normal anatomic structures that limit reflux or by supplementing these structures with a plication or gastroplasty. Individuals with existing severe reflux should not be considered for a sleeve gastrectomy. New techniques that incorporate plication at the time of the index sleeve gastrectomy show some improvement, but these are in small series that will need to be further evaluated. The only proven method of treating intractable reflux after sleeve gastrectomy is conversion to a Roux-en-Y gastric bypass. |
| Databáze: | OpenAIRE |
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