Omentopexy in Sleeve Gastrectomy Reduces Early Gastroesophageal Reflux Symptoms.
Adult
Aged
Bariatric Surgery
/ adverse effects
Endoscopy, Gastrointestinal
/ methods
Female
Gastrectomy
/ adverse effects
Gastroesophageal Reflux
/ diagnostic imaging
Humans
Laparoscopy
/ methods
Longitudinal Studies
Male
Middle Aged
Obesity
/ surgery
Omentum
/ surgery
Postoperative Care
/ methods
Postoperative Complications
/ diagnostic imaging
Preoperative Care
/ methods
Prospective Studies
Radiography
Treatment Outcome
Journal
Surgical laparoscopy, endoscopy & percutaneous techniques
ISSN: 1534-4908
Titre abrégé: Surg Laparosc Endosc Percutan Tech
Pays: United States
ID NLM: 100888751
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
pubmed:
1
12
2018
medline:
31
12
2019
entrez:
1
12
2018
Statut:
ppublish
Résumé
Laparoscopic sleeve gastrectomy (LSG) is one of the surgical procedures indicated in the treatment of obesity. The occurrence of gastroesophageal reflux (GER) in the postoperative period of this surgery is related to a reduction in the lower esophageal sphincter (LES) tone and the presence of gastric residual fundus (RF) associated with increased gastric intraluminal pressure. Fixation of the remaining gastric reservoir to the gastrosplenic and gastrocolic ligaments (omentopexy) has emerged as a technical option to avoid or decrease GER in the postoperative period of LSG. To evaluate the presence of GER symptoms, alterations in LES tone, and the presence of RF in obese subjects submitted to LSG with omentopexy. Twenty obese patients were submitted to LSG with omentopexy from July 2016 to July 2017 at the Hospital Unimed de Teresina, Brazil and was studied prospectively. Clinical evaluations, including a specific questionnaire (clinical score), upper digestive endoscopy and esophageal manometry, were performed preoperatively and on the 90th postoperative day. Contrast x-ray of the esophagus, stomach, and duodenum were performed after the 90th postoperative day. The Fischer exact test was used to evaluate the correlation between GER symptoms and changes in LES tone or the presence of RF. Analysis of variance was used to evaluate the correlation of GER symptoms with the 2 variables together. All analyses adopted a level of significance for α errors >5% (P-value <0.05). The mean clinical score of GER reduced from 6.7 in the preoperative period to 2.7 in the postoperative period. By manometry, there were no significant changes in the LES tone with mean values of 26.04 and 27.07 mm Hg before and after the procedure. RF was identified in 3 cases by contrast radiology. There was no statistical correlation between the changes in the LES tone or the presence of RF with the increase in the clinical score of GER (in cases where this occurred), even when the variables were evaluated together. LSG with omentopexy improved the clinical score of GER in most cases and did not cause significant changes in the LES tone. The presence of RF did not exacerbate the clinical score of GER.
Identifiants
pubmed: 30499891
doi: 10.1097/SLE.0000000000000597
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM