Small hiatal hernia and postprandial reflux after vertical sleeve gastrectomy: A multiethnic Asian cohort

Autor: Jeremy Tan, Eugene Kee Wee Lim, Weng Hoong Chan, Nicholas Syn, Alexander Wei En Tan, Kiat Rui Ng, Chin Hong Lim, Tiffany Jian Ying Lye, Alvin Eng, Shi Min Woo
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Hernia
Physiology
medicine.medical_treatment
Endoscopy
Gastrointestinal
Gastroesophageal Reflux Disease
Medicine and Health Sciences
education.field_of_study
Multidisciplinary
Middle Aged
Postprandial Period
humanities
Treatment Outcome
Physiological Parameters
Sliding Hiatal Hernia
Gastroesophageal Reflux
Medicine
Female
Research Article
Adult
medicine.medical_specialty
Sleeve gastrectomy
Science
Population
Surgical and Invasive Medical Procedures
Gastroenterology and Hepatology
Hiatal hernia
Digestive System Procedures
Signs and Symptoms
Gastrectomy
medicine
Humans
Obesity
education
Retrospective Studies
business.industry
Body Weight
Biology and Life Sciences
Retrospective cohort study
Endoscopy
medicine.disease
digestive system diseases
Surgery
Hernia
Hiatal
GERD
Laparoscopy
Clinical Medicine
business
Zdroj: PLoS ONE, Vol 15, Iss 11, p e0241847 (2020)
PLoS ONE
ISSN: 1932-6203
Popis: Background Laparoscopic vertical sleeve gastrectomy (LSG) is a popular bariatric procedure performed in Asia, as obesity continues to be on the rise in our population. A major problem faced is the development of de novo gastroesophageal reflux disease (GERD) after LSG, which can be chronic and debilitating. In this study, we aim to assess the relationship between the presence of small hiatal hernia (HH) and the development of postoperative GERD, as well as to explore the correlation between GERD symptoms after LSG and timing of meals. In doing so, we hope to gain a better understanding about the type of reflux that occurs after LSG and take a step closer towards effectively managing this difficult to treat condition. Methods We retrospectively reviewed data collected from patients who underwent LSG in our hospital from Dec 2008 to Dec 2016. All patients underwent preoperative upper GI endoscopy, during which the identification of hiatal hernia takes place. Patients' information and reflux symptoms are recorded using standardized questionnaires, which are administered preoperatively, and again during postoperative follow up visits. Results Of the 255 patients, 125 patients (74%) developed de novo GERD within 6 months post-sleeve gastrectomy. The rate of de novo GERD was 57.1% in the group with HH, and 76.4% in the group without HH. Adjusted analysis showed no significant association between HH and GERD (RR = 0.682; 95% CI 0.419 to 1.111; P = 0.125). 88% of the patients who developed postoperative GERD reported postprandial symptoms occurring only after meals, and the remaining 12% of patients reported no correlation between the timing of GERD symptoms and meals. Conclusion There is no direct correlation between the presence of small hiatal hernia and GERD symptoms after LSG. Hence, the presence of a small sliding hiatal hernia should not be exclusion for sleeve gastrectomy. Electing not to perform concomitant hiatal hernia repair also does not appear to result in higher rates of postoperative or de novo GERD.
Databáze: OpenAIRE
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