Impact of concomitant laparoscopic sleeve gastrectomy and hiatal hernia repair on gastro-oesophageal reflux disease in morbidly obese patients

Garg, Harshit; Balasubiramaniyan, Vigneshwaran; Aggarwal, Sandeep; Ahuja, Vineet

doi:10.4103/0972-9941.201730

Cited by 19 publications

(6 citation statements)

References 30 publications

(39 reference statements)

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“…The size of HH is an important factor for its intraoperative management, besides postoperative recurrence and symptoms of reflux. Even though very few studies have reported on the size of HH, they managed it effectively either by simple posterior closure or by using a prosthetic mesh 13,17,18,28 . In the present study, all patients, including around one-fourth of patients with large HH (≥4 cm), were managed with simple interrupted posterior crural closure.…”

Section: Discussionmentioning

confidence: 81%

“…In an earlier study from this center, 20% (1/5) of patients reported PPI use at a short-term follow-up of 11 months, whereas Angrisani and colleagues found this number to be 15.9% (14/88) at a mean follow-up of 7 years after SG + HHR. 4,13 The above findings at different time intervals were interesting to note and require more studies to evaluate the impact of duration on the reflux symptoms after concomitant SG + HHR.…”

Section: Discussionmentioning

confidence: 94%

“…Several questionnaires have been used for the assessment of reflux symptoms in previous studies. 13,18,20 However, due to their complex scoring, they have been either used scarcely or used only at their cutoff point to differentiate between the patients with or without reflux. 21 The current study highlights the use of a 6-point comprehensive, easy-to-use GERD-Q questionnaire (range 0 to 18).…”

Section: Discussionmentioning

confidence: 99%

“…Among various questionnaires, GERD-Q has a high positive predictive value (92%) for the assessment of reflux symptoms and can reduce the need for UGIE, especially in resource-constraint settings 11,12 . To the best of our understanding, no published data are available reporting the GERD outcomes after SG + HHR in the South Asian population, except for the previous study from this center with a smaller sample size 13 . This study aims to assess the outcomes of SG + HHR in patients of severe obesity with or without GERD using GERD-Q questionnaire.…”

mentioning

confidence: 99%

“…11,12 To the best of our understanding, no published data are available reporting the GERD outcomes after SG + HHR in the South Asian population, except for the previous study from this center with a smaller sample size. 13 This study aims to assess the outcomes of SG + HHR in patients of severe obesity with or without GERD using GERD-Q questionnaire.…”

mentioning

confidence: 99%

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Concomitant Hiatal Hernia Repair With Sleeve Gastrectomy: Impact on Gastroesophageal Reflux?

Kumar,

Madhav,

Singla

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Hiatal hernia (HH), whenever encountered during sleeve gastrectomy (SG), needs to be addressed because of its strong association with gastroesophageal reflux disease (GERD). However, the mid-term to long-term effects of hiatal hernia repair (HHR) on GERD remain unclear. Methods: This was a cross-sectional observational analysis of patients who underwent SG + HHR and had completed at least 1 year of follow-up. The preoperative data were retrieved from a prospectively maintained database. Of the 590 patients who underwent SG, 63 patients (10.7%) with concomitant HHR were assessed for the use of proton pump inhibitors (PPIs) and symptoms of GERD using the GERD-Q questionnaire. Results: Of the 63 patients, 11 were lost to follow-up, and one underwent Roux-en-Y gastric bypass for HH recurrence and severe reflux. The remaining 51 patients were assessed at a mean follow-up of 3.7±2.0 years. Of these, 51% (26/51) patients had preoperative reflux symptoms. On follow-up, 69.2% (18/26) had complete resolution with significant improvement in their GERD-Q scores (9.8±3.1 to 6.5±2.1; P=0.001), while 76.2% (16/21) of patients were off the PPIs. The incidence of de novo GERD was found in 20% (5/25) of the patients. Conclusions: In patients of morbid obesity with HH, concomitant HHR with SG leads to improvement of the reflux symptoms in more than two-thirds of the patients, besides alleviating the use of PPIs.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 94%