Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
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
_version_ 1783606885196234752
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
work_keys_str_mv AT lyetiffanyjianying smallhiatalherniaandpostprandialrefluxafterverticalsleevegastrectomyamultiethnicasiancohort
AT ngkiatrui smallhiatalherniaandpostprandialrefluxafterverticalsleevegastrectomyamultiethnicasiancohort
AT tanalexanderweien smallhiatalherniaandpostprandialrefluxafterverticalsleevegastrectomyamultiethnicasiancohort
AT synnicholas smallhiatalherniaandpostprandialrefluxafterverticalsleevegastrectomyamultiethnicasiancohort
AT wooshimin smallhiatalherniaandpostprandialrefluxafterverticalsleevegastrectomyamultiethnicasiancohort
AT limeugenekeewee smallhiatalherniaandpostprandialrefluxafterverticalsleevegastrectomyamultiethnicasiancohort
AT engalvinkimhock smallhiatalherniaandpostprandialrefluxafterverticalsleevegastrectomyamultiethnicasiancohort
AT chanwenghoong smallhiatalherniaandpostprandialrefluxafterverticalsleevegastrectomyamultiethnicasiancohort
AT tanjeremytianhui smallhiatalherniaandpostprandialrefluxafterverticalsleevegastrectomyamultiethnicasiancohort
AT limchinhong smallhiatalherniaandpostprandialrefluxafterverticalsleevegastrectomyamultiethnicasiancohort