Laparoscopic sleeve gastrectomy and gastroesophageal reflux disease: a systematic review and meta-analysis

Oor, Jelmer E.; Roks, David J.; Ünlü, Çağdaş; Hazebroek, Eric J.

doi:10.1016/j.amjsurg.2015.05.031

Cited by 208 publications

(93 citation statements)

References 86 publications

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“…However, the effect of LSG on GERD is still unclear, with conflicting evidence about pre-existing reflux control and the occurrence of de novo GERD after surgery[6]. …”

Section: Introductionmentioning

confidence: 99%

Gastroesophageal reflux disease and morbid obesity: To sleeve or not to sleeve?

Rebecchi

Allaix

Patti

et al. 2017

WJG

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Laparoscopic sleeve gastrectomy (LSG) has reached wide popularity during the last 15 years, due to the limited morbidity and mortality rates, and the very good weight loss results and effects on comorbid conditions. However, there are concerns regarding the effects of LSG on gastroesophageal reflux disease (GERD). The interpretation of the current evidence is challenged by the fact that the LSG technique is not standardized, and most studies investigate the presence of GERD by assessing symptoms and the use of acid reducing medications only. A few studies objectively investigated gastroesophageal function and the reflux profile by esophageal manometry and 24-h pH monitoring, reporting postoperative normalization of esophageal acid exposure in up to 85% of patients with preoperative GERD, and occurrence of de novo GERD in about 5% of cases. There is increasing evidence showing the key role of the surgical technique on the incidence of postoperative GERD. Main technical issues are a relative narrowing of the mid portion of the gastric sleeve, a redundant upper part of the sleeve (both depending on the angle under which the sleeve is stapled), and the presence of a hiatal hernia. Concomitant hiatal hernia repair is recommended. To date, either medical therapy with proton pump inhibitors or conversion of LSG to laparoscopic Roux-en-Y gastric bypass are the available options for the management of GERD after LSG. Recently, new minimally invasive approaches have been proposed in patients with GERD and hypotensive LES: the LINX® Reflux Management System procedure and the Stretta® procedure. Large studies are needed to assess the safety and long-term efficacy of these new approaches. In conclusion, the recent publication of pH monitoring data and the new insights in the association between sleeve morphology and GERD control have led to a wider acceptance of LSG as bariatric procedure also in obese patients with GERD, as recently stated in the 5th International Consensus Conference on sleeve gastrectomy.

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“…However, the effect of LSG on GERD is still unclear, with conflicting evidence about pre-existing reflux control and the occurrence of de novo GERD after surgery[6]. …”

Section: Introductionmentioning

confidence: 99%

Gastroesophageal reflux disease and morbid obesity: To sleeve or not to sleeve?

Rebecchi

Allaix

Patti

et al. 2017

WJG

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“…In this same review, 12 studies including 1863 patients demonstrated a positive impact of sleeve gastrectomy on GERD. A systematic review and meta-analysis examining the relationship between sleeve gastrectomy and GERD included 33 studies [20]. The authors of this study concluded ''because of high heterogeneity among available studies and paradoxical outcomes of objective esophageal function tests, the exact effect of laparoscopic sleeve gastrectomy on the prevalence of GERD remains unanswered.''…”

Section: Discussionmentioning

confidence: 98%

GERD and acid reduction medication use following gastric bypass and sleeve gastrectomy

et al. 2016

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“…Además, hay evidencias clínicas de aparición de novo de síntomas de ERGE, esofagitis y esófago de Barrett después de la gastrectomía en manga (rango 7,8 a 21%). El 80% de los pacientes sometidos a GVT tuvo un reflujo leve a severo, asociado con EEI incompetente u otros mecanismos fisiopatológicos 2,6,[8][9][10][11][12][13][14][15][16][17][18][19][20][21] . Para Tutuian 18 , la presencia de ERGP podría representar una contraindicación relativa para la GVT porque los pacientes pueden desarrollar ERGE y esofagitis después de ella.…”

Section: Consecuencias Clínicasunclassified

Consecuencias clínicas posgastrectomía vertical tubular: enfermedad por reflujo gastroesofágico

Braghetto

2018

Rev Chil Cir

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Clinical consequences post tubular vertical gastrectomy: gastroesophageal reflux disease Several publications report an increase in the rate of gastroesophageal reflux disease (GERD) after surgery, although there is still no consensus on this. The aim of this article is to show our own experience and literature regarding the clinical aspects of GERD disease after tubular vertical gastrectomy. From the analysis of our results and data from the literature, studies evaluating the prevalence of postoperative gastro-oesophageal reflux disease show that GVT can cause symptoms of de novo GERD or worsening of pre-existing GERD.

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Laparoscopic sleeve gastrectomy and gastroesophageal reflux disease: a systematic review and meta-analysis

Cited by 208 publications

References 86 publications

Gastroesophageal reflux disease and morbid obesity: To sleeve or not to sleeve?

Gastroesophageal reflux disease and morbid obesity: To sleeve or not to sleeve?

GERD and acid reduction medication use following gastric bypass and sleeve gastrectomy

Consecuencias clínicas posgastrectomía vertical tubular: enfermedad por reflujo gastroesofágico

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