Standard Anterior Repair of Hiatus Hernia During Laparoscopic Sleeve Gastrectomy Causes a Significant Reduction in Symptoms of GERD
Journal Title: Journal of Medical Science And clinical Research - Year 2015, Vol 3, Issue 5
Abstract
Bariatric surgery is the most effective treatment for gastro-esophageal reflux disease (GERD) in obese patients. Published data reporting the results of laparoscopic sleeve gastrectomy (LSG) and hiatus hernia repair in patients with GERD are contradictory. In this study, we evaluate the effects of standardization of our LSG and Hiatus hernia repair technique on the incidence of postoperative symptoms of GERD. This was a retrospective study. Patients who underwent Laparoscopic sleeve gastrectomy at our centre between Jan 2012 and Dec 2013 were followed up retrospectively with a questionnaire. All patients had been evaluated for hiatus hernia (HH) intraoperatively using a 15ml Balloon pull back technique and all hiatus hernias were repaired with anterior crural approximation. A total of 246 patients underwent surgery. All 246 patients who completed 3–24 months of postoperative follow-up were evaluated. In the study group, 79 patients (32 .1%) were diagnosed with GERD preoperatively, and Hiatus Hernia was detected in 77 patients (30.8 %) intraoperatively. Hiatus Hernia was treated by anterior repair in all pts.There is a significant remission of GERD symptoms post op in patients with hiatus hernia (p=0.003). Most patients with a hiatus hernia repair are asymptomatic post op(p=0.001). Our study confirms a substantial prevalence of GERD symptoms and HH in obese patients. Our results show that standardization of intraoperative hiatus hernia detection and repair can cause a significant reduction in symptoms of GERD patients up to 24 months after surgery and also prevent denovo GERD symptom development after LSG.
Authors and Affiliations
Nandakishore Dukkipati
Keywords
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