Türkçapar Bariatrics, Obesity Center.
Department of Health Sciences, Nişantaşi University.
Surg Laparosc Endosc Percutan Tech. 2022 Aug 1;32(4):449-452. doi: 10.1097/SLE.0000000000001060.
The aim of this study is to reveal incidence of gastroesophageal reflux disease (GERD) after laparoscopic sleeve gastrectomy (LSG) and to determine the effect of LSG with hiatal hernia repair on GERD.
A total of 440 patients, 395 of them underwent primary LSG (group A) and 45 of them underwent LSG with concomitant hiatal hernia repair (group B) between March 2018 and September 2020 were included in the study. Presence of hiatal hernia was evaluated with endoscopy and confirmed intraoperatively. Patients were evaluated for GERD symptoms in the pre and postoperative period. Two groups' data were compared.
Mean age of the 440 patients was 38.4±11 years (56% female) and mean body mass index was 44.2±7 kg/m 2 . Symptomatic GERD was detected in 103 (23.4%) and hiatal hernia was detected in 45 (10.2%) patients. İn the preoperative assessment there was no difference with regard to demographics and symptomatic GERD between the 2 groups. Mean duration of follow-up was 17±5.7 (12 to 28) months in the overall study population. Mean body mass index decreased to 28.3±4.9 kg/m 2 at 12 months after LSG. Excess weight loss ratio was found to be 81±20.4%. The rate of symptomatic GERD after LSG in group A was found to be 20% (n=79/395). Of these patients, 46 (11.6%) had de novo GERD and 33 (38%) had persistent GERD. GERD resolved completely in 54 (62%) patients. In the group B, the rate of symptomatic GERD was detected as 33% (n=15/45) ( P =0.04). The rate of de novo GERD (20%) was also higher in group B ( P =0.03). The rate of persistent GERD (37%) and GERD resolution (62%) were similar in both groups.
İn our study, symptomatic and de novo GERD rates were detected to be higher in the LSG+HH group than LSG alone.
本研究旨在揭示腹腔镜袖状胃切除术（LSG）后胃食管反流病（GERD）的发生率，并确定 LSG 联合食管裂孔疝修补术对 GERD 的影响。
本研究共纳入 2018 年 3 月至 2020 年 9 月期间接受原发性 LSG 的 395 例（A 组）和接受 LSG 联合食管裂孔疝修补术的 45 例（B 组）患者，共 440 例。通过内镜评估食管裂孔疝的存在，并在术中证实。在术前和术后评估患者的 GERD 症状。比较两组数据。
440 例患者的平均年龄为 38.4±11 岁（56%为女性），平均体重指数为 44.2±7kg/m2。103 例（23.4%）患者出现有症状的 GERD，45 例（10.2%）患者出现食管裂孔疝。在术前评估中，两组患者的人口统计学和有症状的 GERD 无差异。总体研究人群的中位随访时间为 17±5.7（12 至 28）个月。LSG 后 12 个月，平均体重指数降至 28.3±4.9kg/m2。超重减轻率为 81±20.4%。A 组 LSG 后有症状 GERD 的发生率为 20%（n=79/395）。其中，46 例（11.6%）患者出现新发 GERD，33 例（38%）患者出现持续性 GERD。54 例（62%）患者 GERD 完全缓解。B 组有症状 GERD 的发生率为 33%（n=15/45）（P=0.04）。B 组新发 GERD 的发生率也较高（20%，P=0.03）。两组持续性 GERD（37%）和 GERD 缓解率（62%）相似。
在本研究中，LSG+HH 组的有症状和新发 GERD 发生率高于 LSG 组。
