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Small hiatal hernia and postprandial reflux after vertical sleeve gastrectomy: A multiethnic Asian cohort
BACKGROUND: Laparoscopic vertical sleeve gastrectomy (LSG) is a popular bariatric procedure performed in Asia, as obesity continues to be on the rise in our population. A major problem faced is the development of de novo gastroesophageal reflux disease (GERD) after LSG, which can be chronic and debi...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7647085/ https://www.ncbi.nlm.nih.gov/pubmed/33156875 http://dx.doi.org/10.1371/journal.pone.0241847 |
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author | Lye, Tiffany Jian Ying Ng, Kiat Rui Tan, Alexander Wei En Syn, Nicholas Woo, Shi Min Lim, Eugene Kee Wee Eng, Alvin Kim Hock Chan, Weng Hoong Tan, Jeremy Tian Hui Lim, Chin Hong |
author_facet | Lye, Tiffany Jian Ying Ng, Kiat Rui Tan, Alexander Wei En Syn, Nicholas Woo, Shi Min Lim, Eugene Kee Wee Eng, Alvin Kim Hock Chan, Weng Hoong Tan, Jeremy Tian Hui Lim, Chin Hong |
author_sort | Lye, Tiffany Jian Ying |
collection | PubMed |
description | BACKGROUND: Laparoscopic vertical sleeve gastrectomy (LSG) is a popular bariatric procedure performed in Asia, as obesity continues to be on the rise in our population. A major problem faced is the development of de novo gastroesophageal reflux disease (GERD) after LSG, which can be chronic and debilitating. In this study, we aim to assess the relationship between the presence of small hiatal hernia (HH) and the development of postoperative GERD, as well as to explore the correlation between GERD symptoms after LSG and timing of meals. In doing so, we hope to gain a better understanding about the type of reflux that occurs after LSG and take a step closer towards effectively managing this difficult to treat condition. METHODS: We retrospectively reviewed data collected from patients who underwent LSG in our hospital from Dec 2008 to Dec 2016. All patients underwent preoperative upper GI endoscopy, during which the identification of hiatal hernia takes place. Patients' information and reflux symptoms are recorded using standardized questionnaires, which are administered preoperatively, and again during postoperative follow up visits. RESULTS: Of the 255 patients, 125 patients (74%) developed de novo GERD within 6 months post-sleeve gastrectomy. The rate of de novo GERD was 57.1% in the group with HH, and 76.4% in the group without HH. Adjusted analysis showed no significant association between HH and GERD (RR = 0.682; 95% CI 0.419 to 1.111; P = 0.125). 88% of the patients who developed postoperative GERD reported postprandial symptoms occurring only after meals, and the remaining 12% of patients reported no correlation between the timing of GERD symptoms and meals. CONCLUSION: There is no direct correlation between the presence of small hiatal hernia and GERD symptoms after LSG. Hence, the presence of a small sliding hiatal hernia should not be exclusion for sleeve gastrectomy. Electing not to perform concomitant hiatal hernia repair also does not appear to result in higher rates of postoperative or de novo GERD. |
format | Online Article Text |
id | pubmed-7647085 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-76470852020-11-16 Small hiatal hernia and postprandial reflux after vertical sleeve gastrectomy: A multiethnic Asian cohort Lye, Tiffany Jian Ying Ng, Kiat Rui Tan, Alexander Wei En Syn, Nicholas Woo, Shi Min Lim, Eugene Kee Wee Eng, Alvin Kim Hock Chan, Weng Hoong Tan, Jeremy Tian Hui Lim, Chin Hong PLoS One Research Article BACKGROUND: Laparoscopic vertical sleeve gastrectomy (LSG) is a popular bariatric procedure performed in Asia, as obesity continues to be on the rise in our population. A major problem faced is the development of de novo gastroesophageal reflux disease (GERD) after LSG, which can be chronic and debilitating. In this study, we aim to assess the relationship between the presence of small hiatal hernia (HH) and the development of postoperative GERD, as well as to explore the correlation between GERD symptoms after LSG and timing of meals. In doing so, we hope to gain a better understanding about the type of reflux that occurs after LSG and take a step closer towards effectively managing this difficult to treat condition. METHODS: We retrospectively reviewed data collected from patients who underwent LSG in our hospital from Dec 2008 to Dec 2016. All patients underwent preoperative upper GI endoscopy, during which the identification of hiatal hernia takes place. Patients' information and reflux symptoms are recorded using standardized questionnaires, which are administered preoperatively, and again during postoperative follow up visits. RESULTS: Of the 255 patients, 125 patients (74%) developed de novo GERD within 6 months post-sleeve gastrectomy. The rate of de novo GERD was 57.1% in the group with HH, and 76.4% in the group without HH. Adjusted analysis showed no significant association between HH and GERD (RR = 0.682; 95% CI 0.419 to 1.111; P = 0.125). 88% of the patients who developed postoperative GERD reported postprandial symptoms occurring only after meals, and the remaining 12% of patients reported no correlation between the timing of GERD symptoms and meals. CONCLUSION: There is no direct correlation between the presence of small hiatal hernia and GERD symptoms after LSG. Hence, the presence of a small sliding hiatal hernia should not be exclusion for sleeve gastrectomy. Electing not to perform concomitant hiatal hernia repair also does not appear to result in higher rates of postoperative or de novo GERD. Public Library of Science 2020-11-06 /pmc/articles/PMC7647085/ /pubmed/33156875 http://dx.doi.org/10.1371/journal.pone.0241847 Text en © 2020 Lye et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Lye, Tiffany Jian Ying Ng, Kiat Rui Tan, Alexander Wei En Syn, Nicholas Woo, Shi Min Lim, Eugene Kee Wee Eng, Alvin Kim Hock Chan, Weng Hoong Tan, Jeremy Tian Hui Lim, Chin Hong Small hiatal hernia and postprandial reflux after vertical sleeve gastrectomy: A multiethnic Asian cohort |
title | Small hiatal hernia and postprandial reflux after vertical sleeve gastrectomy: A multiethnic Asian cohort |
title_full | Small hiatal hernia and postprandial reflux after vertical sleeve gastrectomy: A multiethnic Asian cohort |
title_fullStr | Small hiatal hernia and postprandial reflux after vertical sleeve gastrectomy: A multiethnic Asian cohort |
title_full_unstemmed | Small hiatal hernia and postprandial reflux after vertical sleeve gastrectomy: A multiethnic Asian cohort |
title_short | Small hiatal hernia and postprandial reflux after vertical sleeve gastrectomy: A multiethnic Asian cohort |
title_sort | small hiatal hernia and postprandial reflux after vertical sleeve gastrectomy: a multiethnic asian cohort |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7647085/ https://www.ncbi.nlm.nih.gov/pubmed/33156875 http://dx.doi.org/10.1371/journal.pone.0241847 |
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