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Incidence of de Novo Hiatal Hernia after Laparoscopic Sleeve Gastrectomy

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Abstract

Purpose

After laparoscopic sleeve gastrectomy (LSG), several studies have reported an increase in the incidence of gastroesophageal reflux (GERD). The etiopathogenesis of GERD post-LSG is multifactorial, and hiatal hernia (HH) is one of them.

The primary objective was to measure the incidence of de novo HH post-LSG. The secondary objectives were to relate the presence of HH with GERD, the chronic use of proton pump inhibitors (PPI), and the time elapsed from LSG.

Materials and Methods

A surgical evaluation of the crura after LSG was performed. A retrospective cohort study of 74 consecutive patients with history of LSG submitted to an intra-abdominal surgery that allowed the evaluation of the crura.

Results

Of a total of 74 patients, 51 were included. At the time of surgery, 37 patients (72.5%) had a HH; 24 patients (47.1%) had GERD, and 23 patients (45.1%) were frequently using PPI. When patients with HH and those without HH were compared, GERD was observed in 56.8% versus 21.4% (p = 0.01) and frequent consumption on PPI was found in 54.1% versus 21.4% (p = 0.02). According to the data of LSG, with a follow-up of < 18 months, 60% presented HH; meanwhile, with a follow-up of > 18 months, 84.6% presented HH (p = 0.02).

Conclusions

Patients submitted to LSG showed a high incidence of de novo HH. HH was associated with a higher incidence of GERD and PPI dependence. The longer the time elapsed from the LSG, the greater the incidence of HH.

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Authors and Affiliations

  1. Service of Bariatric and Metabolic Surgery, Indisa Clinic, Avenida Santa María 1810, 7520440, Santiago, Chile

    Jorge Saba, Eugenio Rivas, Roberto Fernández, Alberto Pérez-Castilla & Jorge Zajjur

  2. Surgery Service, Dipreca Hospital, Avenida Vital Apoquindo 1200, 7601003, Santiago, Chile

    Jorge Saba

  3. School of Medicine, Diego Portales University, Dipreca Hospital, Avenida Vital Apoquindo 1200, 7601003, Santiago, Chile

    Jorge Saba

  4. Surgery Service, Luis Tisné Hospital, Avenida Las Torres 5150, 7930124, Santiago, Chile

    Magdalena Bravo

Authors
  1. Jorge Saba
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  2. Magdalena Bravo
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  3. Eugenio Rivas
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  5. Alberto Pérez-Castilla
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Correspondence to Jorge Saba.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Saba, J., Bravo, M., Rivas, E. et al. Incidence of de Novo Hiatal Hernia after Laparoscopic Sleeve Gastrectomy. OBES SURG 30, 3730–3734 (2020). https://doi.org/10.1007/s11695-020-04742-7

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  • DOI: https://doi.org/10.1007/s11695-020-04742-7

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