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Pubmed for Handhelds

PUBMED FOR HANDHELDS

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  • Title: Incidence of de Novo Hiatal Hernia after Laparoscopic Sleeve Gastrectomy.
    Author: Saba J, Bravo M, Rivas E, Fernández R, Pérez-Castilla A, Zajjur J.
    Journal: Obes Surg; 2020 Oct; 30(10):3730-3734. PubMed ID: 32495077.
    Abstract:
    PURPOSE: After laparoscopic sleeve gastrectomy (LSG), several studies have reported an increase in the incidence of gastroesophageal reflux (GERD). The etiopathogenesis of GERD post-LSG is multifactorial, and hiatal hernia (HH) is one of them. The primary objective was to measure the incidence of de novo HH post-LSG. The secondary objectives were to relate the presence of HH with GERD, the chronic use of proton pump inhibitors (PPI), and the time elapsed from LSG. MATERIALS AND METHODS: A surgical evaluation of the crura after LSG was performed. A retrospective cohort study of 74 consecutive patients with history of LSG submitted to an intra-abdominal surgery that allowed the evaluation of the crura. RESULTS: Of a total of 74 patients, 51 were included. At the time of surgery, 37 patients (72.5%) had a HH; 24 patients (47.1%) had GERD, and 23 patients (45.1%) were frequently using PPI. When patients with HH and those without HH were compared, GERD was observed in 56.8% versus 21.4% (p = 0.01) and frequent consumption on PPI was found in 54.1% versus 21.4% (p = 0.02). According to the data of LSG, with a follow-up of < 18 months, 60% presented HH; meanwhile, with a follow-up of > 18 months, 84.6% presented HH (p = 0.02). CONCLUSIONS: Patients submitted to LSG showed a high incidence of de novo HH. HH was associated with a higher incidence of GERD and PPI dependence. The longer the time elapsed from the LSG, the greater the incidence of HH.
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