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Surgical Endoscopy

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13-06-2023 | Gastroesophageal Reflux Disease | Original Article

Postoperative outcomes for sleeve gastrectomy patients with positive pH-defined GERD

Authors: Ila Sethi, Aidan Aicher, Fareed Cheema, Kinga Powers, Amy Rosenbluth, Aurora Pryor, Konstantinos Spaniolas

Published in: Surgical Endoscopy | Issue 9/2023

Abstract

Background

Gastroesophageal reflux disease (GERD) is a possible side effect of sleeve gastrectomy (SG). However, procedure selection for patients with GERD and risk factors for morbidity after bypass surgeries is complex. For patients with a preoperative GERD diagnosis, literature related to worsening postoperative symptoms is discordant.

Objective

This study evaluated the effects of SG on patients with pre-operative GERD confirmed through pH testing.

Setting

University Hospital, United States.

Methods

This was a single-center case-series. SG patients with preoperative pH testing were compared based on DeMeester scoring. Preoperative demographics, endoscopy results, need for conversion surgery, and changes in gastrointestinal quality of life (GIQLI) scores were compared. Two-sample independent t-tests assuming unequal variances were used for statistical analysis.

Results

Twenty SG patients had preoperative pH testing. Nine patients were GERD positive; median DeMeester score 26.7 (22.1–31.15). Eleven patients were GERD negative, with a median DeMeester score of 9.0 (4.5–13.1). The two groups had similar median BMI, preoperative endoscopic findings and use of GERD medications. Concurrent hiatal hernia repair was performed in 22% of GERD positive vs. 36% of GERD negative patients, (p = 0.512). Two patients in the GERD positive cohort required conversion to gastric bypass (22%), while none in the GERD negative cohort did. No significant postoperative differences were noted in GIQLI, heartburn, or regurgitation symptoms.

Conclusion

Objective pH testing may allow the differentiation of patients who would be higher risk for need for conversion to gastric bypass. For patients with mild symptoms, but negative pH testing, SG may represent a durable option.

Graphical Abstract

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Title: Postoperative outcomes for sleeve gastrectomy patients with positive pH-defined GERD
Authors: Ila Sethi
Aidan Aicher
Fareed Cheema
Kinga Powers
Amy Rosenbluth
Aurora Pryor
Konstantinos Spaniolas
Publication date: 13-06-2023
Publisher: Springer US
Keywords: Gastroesophageal Reflux Disease
Sleeve Gastrectomy
Published in: Surgical Endoscopy / Issue 9/2023
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-10149-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Postoperative outcomes for sleeve gastrectomy patients with positive pH-defined GERD

Abstract

Background

Objective

Setting

Methods

Results

Conclusion

Graphical Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Setting

Methods

Results

Conclusion

Graphical Abstract

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