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Short-Term Results of Laparoscopic Sleeve Gastrectomy in Combination with Hiatal Hernia Repair: Experience in a Single Accredited Center

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Abstract

Background

Laparoscopic sleeve gastrectomy (SG), while generally safe and efficacious, may be complicated by gastroesophageal reflux disease (GERD) symptoms as well as the need for hiatus hernia (HH) repair. Identification and management of HH during SG and the effect of HH repair on GERD-related symptoms following SG are controversial.

Objective

This study aimed to evaluate HH repair during SG in morbidly obese patients and its short-term effect on GERD-related symptoms and other clinical outcomes.

Setting

University Hospital, United States

Methods

We retrospectively reviewed patients who underwent primary SG and HH repair. Outcomes included operative time, blood loss, postoperative excess weight loss (%EWL), and self-reported GERD symptoms using a health-related quality of life (HRQL) questionnaire.

Results

For a total of 338 patients, 99 patients (29 %) underwent SG in combination with HH repair; 56 patients (16 %) underwent anterior repair of HH (SG + HH), and 43 patients (13 %) underwent posterior repair with or without mesh placement (SG + paraesophageal hernia (PEH)). We found no significant differences in operative time or blood loss, with significantly higher %EWL at 6 months in SG + HH (n = 43) and SG + PEH (n = 32) compared to SG alone (n = 190). There was also a statistically significant improvement in postoperative GERD symptoms. Finally, SG + HH and SG + PEH patients reported greater satisfaction compared to SG patients (>93 versus 87 %).

Conclusions

SG patients undergoing HH repair experienced higher %EWL, improved GERD symptoms, and greater satisfaction compared to SG alone in the short term. Further studies are needed to clarify long-term outcomes among patients undergoing SG in combination with HH repair.

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Conflict of Interest

The authors declare that they have no competing interests.

Compliance with Ethical Standards

All procedures performed in studies involving human participants 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.

Human and Animal Rights and Informed Consent

For this type of study, formal consent is not required.

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Authors and Affiliations

  1. Department of Surgery, Division of Bariatric and Minimally Invasive Surgery, The Medical School of Temple University, St Luke’s University and Health Network, 240 Cetronia Road, Suite 205, North Allentown, PA, 18104, USA

    Maher El Chaar, George Ezeji, Leonardo Claros & Maureen Miletics

  2. Research Institute and Medical School of Temple University, St. Luke’s University Health Network, Allentown, PA, USA

    Jill Stoltzfus

Authors
  1. Maher El Chaar
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  2. George Ezeji
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  3. Leonardo Claros
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  4. Maureen Miletics
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  5. Jill Stoltzfus
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Correspondence to Maher El Chaar.

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El Chaar, M., Ezeji, G., Claros, L. et al. Short-Term Results of Laparoscopic Sleeve Gastrectomy in Combination with Hiatal Hernia Repair: Experience in a Single Accredited Center. OBES SURG 26, 68–76 (2016). https://doi.org/10.1007/s11695-015-1739-y

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  • DOI: https://doi.org/10.1007/s11695-015-1739-y

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