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01.01.2016 | Original Contributions | Ausgabe 1/2016

Obesity Surgery 1/2016

Short-Term Results of Laparoscopic Sleeve Gastrectomy in Combination with Hiatal Hernia Repair: Experience in a Single Accredited Center

Zeitschrift:
Obesity Surgery > Ausgabe 1/2016
Autoren:
Maher El Chaar, George Ezeji, Leonardo Claros, Maureen Miletics, Jill Stoltzfus

Abstract

Background

Laparoscopic sleeve gastrectomy (SG), while generally safe and efficacious, may be complicated by gastroesophageal reflux disease (GERD) symptoms as well as the need for hiatus hernia (HH) repair. Identification and management of HH during SG and the effect of HH repair on GERD-related symptoms following SG are controversial.

Objective

This study aimed to evaluate HH repair during SG in morbidly obese patients and its short-term effect on GERD-related symptoms and other clinical outcomes.

Setting

University Hospital, United States

Methods

We retrospectively reviewed patients who underwent primary SG and HH repair. Outcomes included operative time, blood loss, postoperative excess weight loss (%EWL), and self-reported GERD symptoms using a health-related quality of life (HRQL) questionnaire.

Results

For a total of 338 patients, 99 patients (29 %) underwent SG in combination with HH repair; 56 patients (16 %) underwent anterior repair of HH (SG + HH), and 43 patients (13 %) underwent posterior repair with or without mesh placement (SG + paraesophageal hernia (PEH)). We found no significant differences in operative time or blood loss, with significantly higher %EWL at 6 months in SG + HH (n = 43) and SG + PEH (n = 32) compared to SG alone (n = 190). There was also a statistically significant improvement in postoperative GERD symptoms. Finally, SG + HH and SG + PEH patients reported greater satisfaction compared to SG patients (>93 versus 87 %).

Conclusions

SG patients undergoing HH repair experienced higher %EWL, improved GERD symptoms, and greater satisfaction compared to SG alone in the short term. Further studies are needed to clarify long-term outcomes among patients undergoing SG in combination with HH repair.

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