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Gastroesophageal Reflux Disease After Laparoscopic Sleeve Gastrectomy with Concomitant Hiatal Hernia Repair: an Unresolved Question

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Abstract

Purpose

The effectiveness of the concomitant repair of hiatal hernia (HHR) during laparoscopic sleeve gastrectomy (LSG) in reducing gastroesophageal reflux disease (GERD) symptoms is still unclear. The aim of this study is to assess the effect of concomitant HHR on postoperative GERD symptoms in our patient population.

Materials and Methods

A retrospective review of patients who underwent LSG with or without HHR between 2011and 2014 was performed. Pre- and postoperative GERD symptoms were assessed at different time intervals until a maximum of 2 years after the surgery.

Results

The study included 165 patients; 76 (46%) underwent LSG with concomitant HHR (group A) while the rest underwent only LSG (group B). Baseline GERD complaints were more prevalent in group A (61.8 vs 41.6%, p = 0.04), in which 44 patients (57.9%) had evidence of hiatal hernia on preoperative EGD. In the remaining 32 patients, it was diagnosed intraoperatively. GERD symptoms did not significantly differ between the two groups after years 1 and 2. GERD remission was observed in 21.3% of the 76 patients who underwent concomitant HHR (group A) and in 29.7% of those who did not (group B) while new-onset GERD symptoms were reported in 12 patients (41.4%) in group A and in 24 patients (46.2%) in group B.

Conclusions

Routine HHR at the time of LSG does not show an improvement in GERD symptoms. More prospective studies are needed to clarify the role of the routine dissection, identification, and repair of concomitant hiatal hernia during LSG.

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Authors and Affiliations

  1. Department of Surgery, American University of Beirut Medical Center, PO Box: 11-0236, Riad El Solh, Beirut, Beirut, 1107 2020, Lebanon

    Hanaa Dakour Aridi, Mohammad Asali, Tarek Fouani, Ramzi S. Alami & Bassem Y. Safadi

Authors
  1. Hanaa Dakour Aridi
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  2. Mohammad Asali
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  3. Tarek Fouani
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  4. Ramzi S. Alami
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  5. Bassem Y. Safadi
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Correspondence to Bassem Y. Safadi.

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The authors declare that they have no conflict of interest.

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

Statement of Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any authors. The study was approved by the Institutional Review Board.

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No funding was received to complete this study.

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Dakour Aridi, H., Asali, M., Fouani, T. et al. Gastroesophageal Reflux Disease After Laparoscopic Sleeve Gastrectomy with Concomitant Hiatal Hernia Repair: an Unresolved Question. OBES SURG 27, 2898–2904 (2017). https://doi.org/10.1007/s11695-017-2702-x

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  • DOI: https://doi.org/10.1007/s11695-017-2702-x

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