Laparoscopic sleeve gastrectomy and gastroesophageal reflux

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.