, Volume 27, Issue 10, pp 3935-3936
Date: 26 Apr 2013

Comments on “Increase in gastroesophageal reflux disease symptoms and erosive esophagitis 1 year after laparoscopic sleeve gastrectomy among obese adults” (doi:10.1007/s00464-012-2593-9)

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To the Editor,

We have read with interest the article by Tai et al. [1] describing the high risk for developing gastroesophageal reflux disease (GERD) 1 year after laparoscopic sleeve gastrectomy.

Sleeve gastrectomy has become one of the most common bariatric procedures performed throughout the world. In the past it was presented as a first step toward completion of a biliopancreatic diversion. Currently, there is ample literature to support sleeve gastrectomy as a stand-alone procedure comparable to laparoscopic Roux-en-Y gastric bypass as a treatment for obesity and its comorbidities. However, the perceived simplicity of this operation belies the complexity of various physiological mechanisms of action which still remain an enigma. One of the most perplexing questions is why patients who undergo sleeve gastrectomy develop GERD? Tai et al. found that the prevalence of GERD symptoms 1 year after surgery was 47 % and only 12 % prior to surgery in a small cohort of 66 patients. In stark co