Abstract
Background and Aims
Laparoscopic sleeve gastrectomy (LSG) might be associated with a new onset or worsening of gastroesophageal reflux disease (GERD). We aim to evaluate the prevalence of post-LSG GERD symptoms and its predictors.
Methods
We included patients who underwent primary LSG at a university hospital from 2009 to 2015. We used the GERD-Health-Related Quality of Life (GERD-HRQL) questionnaire and included questions regarding regurgitation to evaluate symptoms before and after LSG; each item was scored from 1 to 5 based on the symptom severity.
Results
A total of 213 patients (mean age, 36.08 ± 10.22 years; 48.36% were men) were included. The mean preoperative body mass index (BMI) was 47.84 kg/m2, mean percent total weight loss was 37.99% (95% CI, 36.64 to 39.34), mean percent excess weight loss was 84.14% (95% CI, 80.91 to 87.36), and the mean percent excess BMI loss was 84.17% (95% CI, 80.94 to 87.41). The mean heartburn score while standing increased (0.71 vs. 1.09, p < 0.01) as well as the score of heartburn requiring a diet change (0.67 vs. 1.16, p < 0.01) post-LSG. The scores for dysphagia, odynophagia, and regurgitation increased. New-onset heartburn was reported in 47.06% of our cohort. Those with high preoperative BMIs were less likely to develop new-onset or worsening symptoms of GERD (odds ratio [OR], 0.97; 95% confidence interval [CI], 0.95–0.99). More severe heartburn symptoms while standing were associated with higher risks of developing or worsening GERD symptoms (OR, 1.22; 95% CI, 1.01–1.47). None of the other variables could predict the development or worsening of the GERD symptoms.
Conclusion
Symptoms of heartburn and regurgitation are common after LSG; however, none of the variables preoperatively could strongly predict patients who would develop new onset or experience worsening of symptoms postoperatively.
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References
Finucane MM, Stevens GA, Cowan MJ, et al. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2011;377:557–67.
Memish ZA, El Bcheraoui C, Tuffaha M, et al. Obesity and associated factors—Kingdom of Saudi Arabia, 2013. Prev Chronic Dis. 2014;11:E174.
Singh M, Lee J, Gupta N, et al. Weight loss can lead to resolution of gastroesophageal reflux disease symptoms: a prospective intervention trial. Obesity. 2013;21:284–90.
Velanovich V. The development of the GERD-HRQL symptom severity instrument. Dis Esophagus. 2007;20:130–4.
Tolone S, Savarino E, Yates RB. The impact of bariatric surgery on esophageal function. Ann N Y Acad Sci. 2016;1381:98–103.
Chiu S, Birch DW, Shi X, et al. Effect of sleeve gastrectomy on gastroesophageal reflux disease: a systematic review. Surg Obes Relat Dis. 2011;7:510–5.
Gagner M, Hutchinson C, Rosenthal R. Fifth International Consensus Conference: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2016;12:750–6.
Almadi MA, Almousa MA, Althwainy AF, et al. Prevalence of symptoms of gastroesophageal reflux in a cohort of Saudi Arabians: a study of 1265 subjects. Saudi J Gastroenterol. 2014;20:248–54.
Sucandy I, Chrestiana D, Bonanni F, et al. Gastroesophageal reflux symptoms after laparoscopic sleeve gastrectomy for morbid obesity. The importance of preoperative evaluation and selection. N Am J Med Sci. 2015;7:189–93.
Hendricks L, Alvarenga E, Dhanabalsamy N, et al. Impact of sleeve gastrectomy on gastroesophageal reflux disease in a morbidly obese population undergoing bariatric surgery. Surg Obes Relat Dis. 2016;12:511–7.
Del Genio G, Tolone S, Limongelli P, et al. Sleeve gastrectomy and development of “de novo” gastroesophageal reflux. Obes Surg. 2014;24:71–7.
Bolier EA, Kessing BF, Smout AJ, et al. Systematic review: questionnaires for assessment of gastroesophageal reflux disease. Dis Esophagus. 2015;28:105–20.
Fischer L, Wekerle AL, Bruckner T, et al. BariSurg trial: sleeve gastrectomy versus Roux-en-Y gastric bypass in obese patients with BMI 35–60 kg/m(2) - a multi-centre randomized patient and observer blind non-inferiority trial. BMC Surg. 2015;15:87.
Acknowledgements
The authors extend their sincere appreciation to the Deanship of Scientific Research at King Saud University for funding this research through the Research Group Project number RGP-279.
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Majid A Almadi: analysis of the data; writing, drafting, and revising of the manuscript for important intellectual content; and final approval of the version to be published
Saad Althuwaini, Fahad Bamihriz, Abdullah Aldohayen, Waleed Alshammari, Saleh Alhaidar, Mazen Alotaibi, Abdullah Alanazi, Hossam Alsahabi: acquisition of data, revising of the manuscript critically for important intellectual content, and final approval of the version to be published
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Althuwaini, S., Bamehriz, F., Aldohayan, A. et al. Prevalence and Predictors of Gastroesophageal Reflux Disease After Laparoscopic Sleeve Gastrectomy. OBES SURG 28, 916–922 (2018). https://doi.org/10.1007/s11695-017-2971-4
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DOI: https://doi.org/10.1007/s11695-017-2971-4