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Erschienen in: Obesity Surgery 8/2017

24.02.2017 | Original Contributions

Intra-thoracic Sleeve Migration (ITSM): an Underreported Phenomenon After Laparoscopic Sleeve Gastrectomy

verfasst von: Alan A. Saber, Saeed Shoar, Mousa Khoursheed

Erschienen in: Obesity Surgery | Ausgabe 8/2017

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Abstract

Background

Despite its technical simplicity, laparoscopic sleeve gastrectomy (LSG) complications are increasingly reported. Intra-thoracic sleeve migration (ITSM ) is a rare complication after LSG which has been inconsistently addressed in the literature.

Aims

The purpose of this study was to emphasize ITSM occurrence after LSG and evaluate the perioperative factors associated with its development.

Methods

Between January and July 2016, LSG patients diagnosed with ITSM at two bariatric surgery departments were identified. Perioperative factors were assessed for all the patients and compared between two groups, LSG alone and LSG with concomitant hiatal hernia (HH) repair (HHR).

Results

A total of 19 patients (6 males and 13 females) were included. Central obesity was present in 18 patients (94.7%). Nine patients (47.4%) had concomitant hiatal hernia repair during their original LSG. Post-LSG GERD (94.7%) (38.9% de novo and 61.1% recurrent) and post-LSG constipation (57.9%) were commonly associated with ITSM. Severe refractory GERD was the most common presentation for ITSM (94.7%), followed by epigastric pain (47.4%), persistent nausea/vomiting (36.8%), and dysphagia (21.1%). Time interval between primary LSG and ITSM diagnosis ranged from 1 day to 3 years. Patients with LSG and concomitant HHR presented with higher post-LSG BMI compared to the LSG patients (37 ± 6.4 kg/m2 vs. 30.1 ± 6.3 kg/m2, p = 0.03). All the patients underwent successful reduction of ITSM and subsequent HHR.

Conclusion

Central obesity, chronic constipation, post-LSG GERD, and concomitant HHR are commonly seen in post-laparoscopic sleeve gastrectomy intra-thoracic sleeve migration.
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Metadaten
Titel
Intra-thoracic Sleeve Migration (ITSM): an Underreported Phenomenon After Laparoscopic Sleeve Gastrectomy
verfasst von
Alan A. Saber
Saeed Shoar
Mousa Khoursheed
Publikationsdatum
24.02.2017
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 8/2017
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2589-6

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