De novo gastroesophageal reflux disease after sleeve gastrectomy: role of preoperative silent reflux

Borbély, Yves Michael; Schaffner, Emmanuel; Zimmermann, Lara; Huguenin, M; Plitzko, Gabriel; Nett, Philipp C.; Kröll, Dino

doi:10.1007/s00464-018-6344-4

Cited by 82 publications

(47 citation statements)

References 41 publications

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“…Importantly, borderline GERD was noticed in another 40.8% of our population and affected nearly half of our asymptomatic patients. Taken together, 76.2% had at least borderline evidence of GERD with 4.8% of individuals presenting with Barrett's esophagus, which is alarming as the current data illustrate that a large percentage of de novo GERD after sleeve gastrectomy, one of the leading bariatric procedures worldwide, derives from silent preoperative reflux [30]. Based on this, adverse long-term data revealing considerable conversion rates due to GERD-related complications seem understandable [5].…”

Section: Discussionmentioning

confidence: 84%

Modern Esophageal Function Testing and Gastroesophageal Reflux Disease in Morbidly Obese Patients

et al. 2019

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Background The implementation of high-resolution manometry (HRM) and the Lyon Consensus statement facilitate evaluation of gastroesophageal reflux disease and motility disorders in morbidly obese patients. Therefore, we aimed to investigate prevalence and phenotype of (borderline) GERD and esophageal motility disorders in this population. Methods Consecutive morbidly obese (BMI ≥ 35 kg/m 2 ) patients were offered evaluation by means of HRM, ambulatory 24-h pH impedance monitoring, endoscopy, and a clinical examination at our tertiary academic center. Data were collected prospectively.Results Out of 448 eligible individuals, 147 patients (females = 75, 51%) with a median age of 41.6 (33.4; 52.3) years and a BMI of 44 (40.9; 49.4) kg/m 2 were included during the study period. The Chicago Classification revealed motility disorders in 50 (34%) patients, dominated by outflow obstruction (18.4%, n = 27) and a novel disorder (7.5%, n = 11), nicknamed jackhammer esophagus (JE). According to the Lyon Consensus, 52 (35.4%) patients had evidence of true GERD, whereas borderline GERD was noted in another 60 (40.8%). Hypersensitive esophagus was observed in 6.8% (n = 10). Sensitivity and specificity of symptoms for GERD were 53.8% and 68.4%, respectively. Conclusions The current gold standard of assessment revealed that the prevalence of esophageal motility disorders and (borderline) GERD is high in the morbidly obese population. Further longitudinal data are needed to delineate the natural course of novel motility disorders like JE in obesity and to identify risk factors for adverse outcomes following bariatric surgery.

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Section: Discussionmentioning

confidence: 84%

Modern Esophageal Function Testing and Gastroesophageal Reflux Disease in Morbidly Obese Patients

et al. 2019

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“…Laparoscopic sleeve gastrectomy (LSG) is presently considered a safe, easy, and effective stand-alone procedure for the treatment of morbid obesity, in terms of weight loss and comorbidity resolution and with low morbidity [1][2][3][4][5]. For these reasons, LSG quickly gained widespread popularity both in the USA and in Europe [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Manometric and pH-monitoring changes after laparoscopic sleeve gastrectomy: a systematic review

Balla

Meoli

Palmieri

et al. 2021

Langenbecks Arch Surg

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Purpose Aim of this systematic review is to assess the changes in esophageal motility and acid exposure of the esophagus through esophageal manometry and 24-hours pH-monitoring before and after laparoscopic sleeve gastrectomy (LSG). Methods Articles in which all patients included underwent manometry and/or 24-hours pH-metry or both, before and after LSG, were included. The search was carried out in the PubMed, Embase, Cochrane, and Web of Science databases, revealing overall 13,769 articles. Of these, 9702 were eliminated because they have been found more than once between the searches. Of the remaining 4067 articles, further 4030 were excluded after screening the title and abstract because they did not meet the inclusion criteria. Thirty-seven articles were fully analyzed, and of these, 21 further articles were excluded, finally including 16 articles. Results Fourteen and twelve studies reported manometric and pH-metric data from 402 and 547 patients, respectively. At manometry, a decrease of the lower esophageal sphincter resting pressure after surgery was observed in six articles. At 24-hours pH-metry, a worsening of the DeMeester score and/or of the acid exposure time was observed in nine articles and the de novo gastroesophageal reflux disease (GERD) rate that ranged between 17.8 and 69%. A meta-analysis was not performed due to the heterogeneity of data. Conclusions After LSG a worsening of GERD evaluated by instrumental exams was observed such as high prevalence of de novo GERD. However, to understand the clinical impact of LSG and the burden of GERD over time further long-term studies are necessary.

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“…Conflicting studies: likely worsens reflux. [55][56][57][58][59][60][61][62][63] SM-BOSS trial with 5-year follow-up showed worsening reflux. 61 Division of diaphragmatic crural ligaments and disruption of angle of His resulting in lower LES pressures.…”

Section: Restrictivementioning

confidence: 96%

“…58 Another study of 222 patients undergoing SG showed that 52.0% of patients complained of postoperative GERD symptoms, of which 73.0% were de novo. 59 Also, of concern is an increase in post-operative asymptomatic reflux, as described by Pilone et al 60 Studies assessing long-term outcomes of SG have offered further evidence of worsening GERD symptoms. The Swiss Multicenter Bypass or Sleeve Study trial evaluated 5-year postoperative outcomes of SG versus RYGB.…”

Section: Laparoscopic Sleeve Gastrectomymentioning

confidence: 99%

The Effect of Bariatric Surgery and Endoscopic Procedures on Gastroesophageal Reflux Disease

Fass

Mashimo

2021

J Neurogastroenterol Motil

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De novo gastroesophageal reflux disease after sleeve gastrectomy: role of preoperative silent reflux

Abstract: LSG leads to a considerable rate of post-operative GERD. De novo-GERD consist of around half of pre-operative silent GERD and completely de novo-GERD. Most patients with pre-operative silent GERD became symptomatic.

Cited by 82 publications

References 41 publications

Modern Esophageal Function Testing and Gastroesophageal Reflux Disease in Morbidly Obese Patients

Modern Esophageal Function Testing and Gastroesophageal Reflux Disease in Morbidly Obese Patients

Manometric and pH-monitoring changes after laparoscopic sleeve gastrectomy: a systematic review

The Effect of Bariatric Surgery and Endoscopic Procedures on Gastroesophageal Reflux Disease

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