Table 3.
Positive impact of a sleeve gastrectomy on gastroesophageal reflux disease
| Ref. | Nature of the study | Patients, n | Pre-operative BMI (kg/m2) | GERD evaluation | Follow-up (mo) | GERD (%) Preop | GERD (%) Postop |
| Melissas et al[39], 2008 | Prospective study | 14 | 49.5 | CA | 24 | 2 (14%) | 1 (7%) |
| Nocca et al[40], 2008 | Multicenter prospective study | 163 | 45.9 | NA | 24 | 10 (6.1%) | 6 (3.6%) |
| Petersen et al[41], 2012 | Prospective study: 3 groups | 37 | 50.5 and 47.5 | CA; EM | NA | NA | LESP: 8.4 to 21.2 mmHg may protect against GERD |
| Chopra et al[42], 2012 | Retrospective review and analysis | 185 | 49.0 | CA; EGD | 6 | NA | Improvement: 46% |
| De novo: 3.2% | |||||||
| Daes et al[35], 2012 | Concurrent cohort study | 134 | 39.0 | CA; EGD | 12 | 49.2% | 1.50% |
| Rawlins et al[43], 2013 | Retrospective study | 55 | 65.0 | CA; NA | 60 | 27% | 27% |
| 53% resolution | |||||||
| 16% de novo | |||||||
| Santonicola et al[37], 2013 | Retrospective comparative | 180 | LSG: 36.5 | CA | 13-18 | LSG: 39.2 % | LSG: 22.5%, de novo: 17.7% |
| LSG vs LSG + HHR | 78 LSG | LSG + HHR: 39.3 | EGD | LSG + HHR: 38.4% | LSG+HHR: 43.3%, de novo: 22.9% | ||
| 102 LSG + HHR | If GERD: dc - BM | ||||||
| Sharma et al[19], 2014 | Prospective study | 32 | 47.8 | CDS | 12 | CDS: 2.88 | CDS: 1.63 (P < 0.05) |
| GERD SS | SS: 2.28 | SS: 1.06 (P < 0.05) | |||||
| EGD | RS: 6.25% | RS: 78.1%(P < 0.001) | |||||
| RS | Esophagitis: 18.8% | Esophagitis: 25%, reduction of severity | |||||
| Rebecchi et al[20], 2014 | Prospective study | 71 | 44.3 | GSAS | 24 | A: | A: |
| A: PAE | EGD | GSAS: 53.1 | GSAS: 13.1 | ||||
| B: NAE | BM | Demeester: 39.5 | Demeester: 10.6 | ||||
| EM | B: | B: | |||||
| 24-h pH | Demeester: 11.9 | Demeester: 12 | |||||
| de novo: 5.4% | |||||||
| Pallati et al[38], 2014 | Prospective database | 585 | 48.5 | GERD-symptom grading based on medication use | 6 | All patients included | Score improvement 41% |
| Worsening: 4.6 % | |||||||
| de novo: 9.2% | |||||||
| Del genio et al[44], 2014 | Prospective database | 25 | 46.1 | CA; HRiM, MII-pH | 13 | Patient excluded if preop. GERD | No de novo GERD |
| Retrospective analysis | |||||||
| Daes et al[36], 2014 | Prospective evaluation | 382 | 37.7 | CA | 22 | 44.5% | 2.6% |
| EGD | 94% resolution of symptoms | ||||||
| Total: 12 studies |
NA: Not available; CA: Clinical assessment; UGICS: Upper gastrointestinal contrast series; LSG: Laparoscopic sleeve gastrectomy; HHR: Hiatal hernia repair; EGD: Esophogastroduodenoscopy; GERD: Gastroesophageal reflux disease; dc-BM: Double contrast after a barium meal; CDQ: Carlsson Dent Score; GERD SS: GERD Symptom Score; RS: Radionuclide scintigraphy; GSAS: Gastroesophageal Reflux Disease Symptom Assessment Scale; EM: Esophageal manometry; PAE: Pathologic acid exposure; NAE: Normal acid exposure; HRiM: High-resolution impedance manometry; MII-pH: Combined 24-H pH-multichannel intraluminal impedance; LESP: Lower esophageal sphincter pressure.