Comment on: Sleeve gastrectomy with concomitant hiatal hernia repair in obese patients: long-term results on gastroesophageal reflux disease
| Autor: | Antonella Santonicola, Luigi Angrisani, Paola Iovino, V. Borrelli |
|---|---|
| Přispěvatelé: | Angrisani, Luigi, Santonicola, Antonella, Borrelli, Vincenzo, Iovino, Paola |
| Rok vydání: | 2020 |
| Předmět: |
Sleeve gastrectomy
medicine.medical_specialty medicine.drug_class medicine.medical_treatment MEDLINE Proton-pump inhibitor Hiatal Hernia recurrence 030209 endocrinology & metabolism Disease Gastroesophageal reflux disease Hiatal hernia repair 03 medical and health sciences 0302 clinical medicine Gastrectomy medicine Humans Obesity Esophagus Herniorrhaphy Retrospective Studies business.industry Reflux Long term results medicine.disease humanities digestive system diseases Surgery medicine.anatomical_structure Hernia Hiatal Concomitant GERD Gastroesophageal Reflux 030211 gastroenterology & hepatology Laparoscopy Neoplasm Recurrence Local business Esophagitis |
| Zdroj: | Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 16(9) |
| ISSN: | 1878-7533 |
| Popis: | Background Hiatal hernia repair (HHR) during Sleeve Gastrectomy (SG) is recommended when the defect is intraoperatively found; however, the long term effect on gastro-esophageal reflux disease (GERD) remains controversial. Objectives This study aimed to report long-term follow-up data, at least after 7 years, of SG with concomitant HHR and the outcome on GERD symptoms. Setting Tertiary-care referral hospital. Methods This study retrospectively analyzed 91 obese patients submitted to SG + HHR with a minimum of 7-years follow-up. The preoperative evaluation included GERD symptoms assessment by a standardized questionnaire, proton pump inhibitor usage evaluation, an upper gastrointestinal endoscopy, and a barium-swallow esophagogram to detect the presence of HH. At long-term follow-up visit, GERD assessment was performed to evaluate remission, persistence, or new onset of typical GERD symptoms; proton pump inhibitor usage was also investigated. Patients underwent barium-swallow esophagogram and/or upper gastrointestinal endoscopy. Results At long-term evaluation, 2 of 91 patients (2.2%) were lost and 1 patient underwent Roux-en-Y gastric bypass. Of patients with preoperative GERD, 60% had GERD resolution; however, 27 of 88 (30.6%) patients reported postoperative GERD symptoms. Among these patients 15 (55.5%) showed the HH recurrence detected by barium-swallow esophagogram. All patients with HH recurrence had esophagitis and 1 case had a Barrett’s esophagus. In the remaining 12 patients (44.4%) with postoperative GERD without HH recurrence, the barium-swallow esophagogram showed signs of reflux in reverse Trendelenburg. Conclusions At long-term follow-up HH recurrence was consistently related to the presence of GERD symptoms and to a high rate of esophagitis and Barrett’s esophagus. In all patients with GERD symptoms after SG + HHR, a HH recurrence should be suspected and an upper gastrointestinal endoscopy strongly recommended to rule out esophagitis, and especially Barrett’s esophagus. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|