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Gastroesophageal Reflux After Sleeve Gastrectomy: New Onset and Effect on Symptoms on a Prospective Evaluation

  • Vincenzo Pilone
  • Salvatore TramontanoEmail author
  • Michele Renzulli
  • Claudio Zulli
  • Luigi Schiavo
Original Contributions

Abstract

Background

Gastroesophageal reflux disease (GERD) is present in half of the obese candidates for bariatric surgery. Variability of symptoms and new onset of GERD are often debated. Prior studies have demonstrated that sleeve gastrectomy (SG) is associated with significant weight loss.

Objectives

We prospectively evaluated the effect of a standardized SG technique on GERD symptoms in 104 patients.

Methods

All patients were surveyed on the presence of heartburn and/or regurgitation with a specific questionnaire (GERD-HRQL). Esophagogastroduodenoscopy (EGDS) was performed in the preoperative phase and after 12 months.

Results

All patients completed a 12-month follow-up. In the preoperative phase, 27.9% presented GERD symptoms (29 cases), while endoscopic findings were observed in 19.2% (20 cases). Preoperative GERD was ameliorated/solved in 65.5% of cases. The mean value of the GERD-HRQL score was significantly lower in postoperative evaluation (33.8 vs 19.4; p < 0.05). At 12-month EGDS, esophagitis was present in 13.5%, and GERD-HRQL symptoms were recorded in 10.6%. Considering patients treated until December 2015 (group 1, 44 patients) and those treated after December 2015 (group 2, 60 patients), all new clinical and endoscopic GERD diagnoses were observed in group 1; the majority of unsolved GERD cases was present in Ggoup 1 (8 vs 2; p < 0.05).

Conclusion

Significant amelioration on preoperative GERD was confirmed after SG. New characteristics of reflux are emerging in SG patients, often asymptomatic. Standardization is necessary to define the real effect of SG on GERD.

Keywords

Sleeve gastrectomy Gastroesophageal reflux GERD-HRQL Obesity Esophagitis 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Human Rights

All procedures were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Specific informed consent was obtained by each patient, and the local Institutional Ethical Committee approved the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Medicine, Surgery, and DentistryUniversity of SalernoSalernoItaly
  2. 2.General, Bariatric and Emergency Surgical Unit of Fucito HospitalUniversity Hospital of SalernoSalernoItaly
  3. 3.Endoscopic Unit of Fucito HospitalUniversity Hospital of SalernoSalernoItaly
  4. 4.Department of Cardio-Thoracic and Respiratory ScienceUniversity of Campania “Luigi Vanvitelli”NaplesItaly
  5. 5.IX Division of General Surgery, Vascular Surgery, and Applied BiotechnologyNaples University PolyclinicNaplesItaly

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