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GERD and sleeve gastrectomy

Ricardo Mohammed, Patrick Fei, John Phu, Megumi Asai, Gintaras Antanavicius
BACKGROUND: Gastroesophageal reflux (GERD) is a symptom frequently found in obese patients, and often is related to the presence of a hiatal hernia (HH). Surgeons may evaluate for the presence of HH on esophagogastroduodenoscopy (EGD). However, preoperative endoscopic presence or absence of a significant HH does not always correlate with intraoperative findings. OBJECTIVE: To compare the rate of detection of repairable HH between clinical, endoscopic, and intraoperative methods SETTING: Independent, university-affiliated teaching hospital METHODS: A retrospective chart review of all consecutive patients who had undergone a primary bariatric procedure sleeve gastrectomy, gastric bypass, or biliopancreatic diversion/duodenal switch with routine preoperative EGD in a single institution from 2009-2013 was performed...
August 17, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Doulami Georgia, Triantafyllou Stamatina, Natoudi Maria, Albanopoulos Konstantinos, Filis Konstantinos, Leandros Emmanouil, Zografos Georgios, Theodorou Dimitrios
INTRODUCTION: It is not yet clear if laparoscopic sleeve gastrectomy (LSG) causes newly onset gastroesophageal reflux (GERD) or worsens already existing GERD. This is due to the absence of prospective studies using objective assessment measures of GERD such as pH monitoring. Our study aims at assessing GERD 1-year post-LSG procedure for obesity. MATERIALS AND METHODS: Twelve asymptomatic obese patients were studied prospectively by using 24-h multichannel intraluminal impedance-pHmetry (MIIpH) pre- and 12 months post-LSG...
September 3, 2016: Obesity Surgery
Maher El Chaar, Jill Stoltzfus, Leonardo Claros, Maureen Miletics
INTRODUCTION: Bariatric surgery is the only proven and effective long-term treatment for morbid obesity, with laparoscopic sleeve gastrectomy (LSG) being the most commonly performed weight loss procedure in the USA. Despite its safety and efficacy, LSG's association with both de novo and pre-existing gastroesophageal reflux disease (GERD) remains controversial. METHODS: Therefore, this retrospective study determined the incidence, indications, and outcomes of revisional surgery following LSG in adult patients at our institution from 2010 to 2014...
August 30, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
R Zorron, C Bothe, T Junghans, J Pratschke, C Benzing, F Krenzien
The Roux-en-Y gastric bypass (RYGB) is the therapy of choice in bariatric surgery. Sleeve gastrectomy and gastric banding are showing higher rates of treatment failure, reducing obesity-associated morbidity and body weight insufficiently. Moreover, gastroesophageal reflux disease (GERD) can occur refractory to medication. Therefore, a laparoscopic conversion to RYGB can be reasonable as long as specific conditions are fulfilled.Endoscopic procedures are currently being applied to revise bariatric procedures...
October 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Verónica Gorodner, Rudolf Buxhoeveden, Gastón Clemente, Christian Sánchez, Luis Caro, Alejandro Grigaites
INTRODUCTION: Barrett's esophagus (BE) is recognized as a premalignant lesion for esophageal adenocarcinoma. BE appears as a consequence of gastroesophageal reflux disease (GERD), which is increased among obese population. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the best treatment option for obesity combined with GERD. However, data on evolution of BE after LRYGB are scarce. METHODS AND PROCEDURES: Patients were studied with esophagogastroduodenoscopy (EGD) and gastric biopsy preoperatively...
August 23, 2016: Surgical Endoscopy
Antonio Iannelli, Tarek Debs, Francesco Martini, Benjamin Benichou, Imed Ben Amor, Jean Gugenheim
BACKGROUND: Laparoscopic sleeve gastrectomy (SG) has gained popularity as a standalone procedure. However, long-term complications are reported, mainly weight loss failure and gastroesophageal reflux disease (GERD). Therefore, demand for revisional surgery is rising. OBJECTIVES: The aim of this study was to report preliminary results within the 2 main indications for laparoscopic conversion of SG to Roux-en-Y gastric bypass (RYGB). SETTING: University Hospital, France...
April 12, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Tigran Poghosyan, Andrea Lazzati, David Moszkowicz, Divya Danoussou, Karina Vychnevskaia, Daniel Azoulay, Sebastien Czernichow, Claire Carette, Jean-Luc Bouillot
BACKGROUND: Weight loss failure and proton pomp inhibitor (PPI)-resistant gastroesophageal reflux diseases (GERD) after sleeve gastrectomy (SG) are frequently encountered. OBJECTIVES: The aim of this study was to evaluate the efficacy and risks of SG conversion to Roux-en-Y gastric bypass (RYGB) in the case of weight loss failure or severe GERD. SETTING: University hospitals. METHODS: Between March 2007 and December 2014, 34 patients with history of SG underwent RYGP...
March 2, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Salvatore Tolone, Edoardo Savarino, Robert B Yates
Obesity is a worldwide epidemic. There is increasing evidence that obesity is associated with benign gastroesophageal disease, including gastroesophageal reflux disease (GERD) and esophageal dysmotility. Bariatric surgery-including sleeve gastrectomy, gastric bypass, and adjustable gastric band placement-can effectively result in weight loss and control of obesity-related conditions, including GERD. However, there is increasing evidence that bariatric surgery itself can have a deleterious effect on esophageal function...
June 15, 2016: Annals of the New York Academy of Sciences
Alex C Barr, Matthew J Frelich, Matthew E Bosler, Matthew I Goldblatt, Jon C Gould
BACKGROUND: Gastroesophageal reflux disease is a common comorbid medical condition of obesity. Laparoscopic sleeve gastrectomy has been associated with de novo and worsening GERD following surgery. For this reason, patients who suffer from GERD and are considering bariatric surgery are often counseled to undergo gastric bypass. Given this practice, we sought to determine acid reduction medication (ARM) utilization in bariatric surgical patients who undergo one of these procedures prior to surgery and at 1 year following surgery...
June 10, 2016: Surgical Endoscopy
David Nocca, El Mehdi Skalli, Eric Boulay, Marius Nedelcu, Jean Michel Fabre, Marcelo Loureiro
BACKGROUND: Sleeve gastrectomy (SG) is one of the most frequently performed bariatric procedures worldwide. Despite its impressive results, there is a growing concern about the relationship between SG and gastroesophageal reflux disease (GERD). OBJECTIVES: We present our pilot study of patients operated with a Nissen anti-reflux valve added to a standard SG. SETTING: University hospital in Montpellier, France. METHODS: A prospective monocentric study including 25 consecutive patients operated with a laparoscopic Nissen-Sleeve (N-Sleeve) gastrectomy was carried out between September 2013 and March 2014...
February 22, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Gustavo A Arman, Jacques Himpens, Jeroen Dhaenens, Thierry Ballet, Ramon Vilallonga, Guido Leman
BACKGROUND: More than 10 years of outcomes for sleeve gastrectomy (LSG) have not yet been documented. OBJECTIVES: Analysis of>11 years of outcomes of isolated LSG in terms of progression of weight, patient satisfaction, and evolution of co-morbidities and gastroesophageal reflux disease (GERD) treatment. SETTING: Two European private hospitals. METHODS: Chart review and personal interview in consecutive patients who underwent primary isolated LSG (2001-2003)...
January 19, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Ralph P M Gadiot, L Ulas Biter, Stefanie van Mil, Hans F Zengerink, J Apers, Guido H H Mannaerts
INTRODUCTION: Although long-term results of sleeve gastrectomy (LSG) remain scarce in the literature, its popularity as a stand-alone procedure has accounted for a global increase in LSG performance. In this retrospective study, the authors present 5 to 8-year follow-up results in terms of weight loss, failure/revision rate, and comorbidity resolution from a single center. MATERIALS AND METHODS: A prospectively maintained database was reviewed for patients who underwent LSG between 2007 and 2010...
May 14, 2016: Obesity Surgery
Rishi D Naik, Yash A Choksi, Michael F Vaezi
Bariatric surgery has come to the forefront of weight loss treatment due to its complex interactions via anatomic, physiologic, and neurohormonal changes leading to sustained weight loss. Unlike lifestyle and pharmacologic options, which fail to show long-term sustained weight loss, bariatric surgery has been shown to decrease overall mortality and morbidity. Bariatric surgery can be purely restrictive, such as laparoscopic adjustable gastric band (LAGB) or laparoscopic sleeve gastrectomy (LSG), or restrictive-malabsorptive, such as Roux-en-Y gastric bypass (RYGB)...
December 2015: Gastroenterology & Hepatology
Jessica L Reynolds, Joerg Zehetner, Sharon Shiraga, John C Lipham, Namir Katkhouda
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has emerged as an effective weight-loss procedure for morbid obesity that is also effective for treating comorbidities such as diabetes. However, it has been associated with the development of GERD postoperatively. The pathophysiology of post-LSG GERD is unknown, and current studies have shown conflicting results. The aim of our study is to shed light on this issue by investigating the effect of LSG on the lower esophageal sphincter (LES) function and the relationship of LES function to GERD symptoms...
April 12, 2016: Surgical Endoscopy
Tammy L Kindel, Dmitry Oleynikov
Obesity and gastroesophageal reflux disease (GERD) are prevalent in Western populations. In obese patients, high-resolution manometry often shows altered gastroesophageal pressure gradients, promoting retrograde gastric content flow into the esophagus and esophagogastric junction disruption, leading to a hiatal hernia. Hernia recurrence is higher in the obese, and recurrence is seen regardless of the operative approach used. Bariatric surgery is the gold-standard treatment for GERD in obese patients, and symptom improvement varies depending on the specific bariatric procedure performed, Roux-en-Y (RYGB), laparoscopic adjustable gastric banding (LAGB), or sleeve gastrectomy (SG)...
April 2016: Obesity Surgery
Andrés Sánchez-Pernaute, Pablo Talavera, Elia Pérez-Aguirre, Inmaculada Domínguez-Serrano, Miguel Ángel Rubio, Antonio Torres
BACKGROUND: Observational studies based on quality-of-life and endoscopy relate sleeve gastrectomy (SG) to gastroesophageal reflux disease (GERD), while some functional studies have demonstrated a decrease in esophageal exposure to gastric acid after SG. Currently, it is recommended to treat hiatal hernia along with the SG. However, as the sleeve gastrectomy involves the resection of the fundus, it is not possible to add a traditional fundoplication to the closure of the hiatus. METHODS: Based on the classic works of Hill et al...
April 2016: Obesity Surgery
Lars Nelson, Andre F Teixeira, Muhammad A Jawad
No abstract text is available yet for this article.
May 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Mohamed Abdelgawad, Francesco De Angelis, Angelo Iossa, Mario Rizzello, Giuseppe Cavallaro, Gianfranco Silecchia
BACKGROUND: Laparoscopic revisional bariatric surgery (RBS) is increasingly common. A tailored decision-making process is advocated. In this retrospective study, we reviewed the RBS experience of a single center, analyzing perioperative complications to provide insight into management options and midterm outcomes. METHODS: Records from November 2011 to March 2015 were reviewed from prospectively maintained database. Six hundred eighteen patients underwent laparoscopic bariatric procedures; of these, 81 (13...
September 2016: Obesity Surgery
Abraham Abdemur, Sang-Moon Han, Emanuele Lo Menzo, Samuel Szomstein, Raul Rosenthal
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) as a primary bariatric procedure has gained significant popularity. Conversion to Roux-en-Y gastric bypass (RYGBP) or Roux-en-Y esophagojejunostomy (LRYEJ) has been described as a treatment option for inadequate weight loss after LSG and unresolved co-morbidities or complications such as leak, stricture, and severe gastroesophageal reflux disease (GERD). OBJECTIVES: To determine reasons and outcomes of conversions of LSG to RYGBP...
January 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
LéShon Hendricks, Emanuela Alvarenga, Nisha Dhanabalsamy, Emanuele Lo Menzo, Samuel Szomstein, Raul Rosenthal
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has established popularity as a weight loss procedure based on its success. However, LSG's effect on gastroesophageal reflux disease (GERD) is unknown. OBJECTIVES: To analyze the incidence of GERD after LSG and to compare the results in patients with preexisting and de novo GERD. SETTING: Tertiary Medical center. METHODS: The authors performed a retrospective review of primary LSG from 2005 to 2013 and compared patients with pre-existing and de novo GERD who underwent LSG...
March 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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