scholarly journals EP.TH.267Gastroesophageal Reflux Disease after sleeve gastrectomy

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Shujhat Khan ◽  
Sima Al Asad
Keyword(s):  
Sleeve Gastrectomy ◽  
Reflux Disease ◽  
De Novo ◽  
Physiological Anatomy ◽  
Ovid Medline ◽  
Mesh Terms ◽  
Increased Risk ◽  
Gastric Pressure ◽  
High Prevalence ◽  
Patient Groups

Abstract Aim A prominent complication of a sleeve gastrectomy is gastroesophageal disease (GERD). Symptoms include chest pain, dysphagia, heartburn, regurgitation, chronic cough, and laryngitis. With the rise in obesity, and the already high prevalence of GERD in these populations, this is a significant cause of morbidity in western populations and is likely set to worsen. Method The literature search was carried out using Ovid MEDLINE and PubMed databases to search for keywords and MeSH terms including “bariatric surgery”, “sleeve gastrectomy”, “complications”, “gastroesophageal reflux disease”, “GERD”, “GORD”, and “obesity”. Result Approximately 20% of patients who undergo SG will develop de-novo GERD whilst 19% will have an increase in reflux symptoms. The exact mechanism of GERD in both obesity and post-operatively following SG is unclear. However, it can involve several different mechanisms. This includes poor surgical technique, disruption to physiological anatomy, increase in gastric pressure, increased risk of hiatus hernia, and disruption to normal hormonal balance. An effective approach to treat GERD includes the Stretta procedure with studies showing 72% of patients being symptom-free after 10 years. If this fails, conversion of SG to Roux-en-Y is effective but there is an increased risk of gastro-jejunal anastomotic leak (3% vs 1%). Alternatively, addition of hiatoplasty and 180° cardioplication can also be effective. Conclusion More evidence and international collaborations would help determine which patient groups require counselling and will benefit from novel management to minimise complications.

scholarly journals De novo gastroesophageal reflux disease after sleeve gastrectomy: role of preoperative silent reflux

2018 ◽  
Vol 33 (3) ◽  
pp. 789-793 ◽  
Author(s):  
Yves Borbély ◽  
Esther Schaffner ◽  
Lara Zimmermann ◽  
Michael Huguenin ◽  
Gabriel Plitzko ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
De Novo

Hiatal Hernia Repair during Laparoscopic Sleeve Gastrectomy: Systematic Review and Meta-analysis on Gastroesophageal Reflux Disease symptoms changes

2021 ◽  
Vol 93 (5) ◽  
pp. 1-5
Author(s):  
Piotr Małczak ◽  
Magdalena Pisarska-Adamczyk ◽  
Piotr Zarzycki ◽  
Michał Wysocki ◽  
Piotr Major
Keyword(s):  
Systematic Review ◽  
Sleeve Gastrectomy ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Hernia Repair ◽  
Hiatal Hernia ◽  
Reflux Disease ◽  
De Novo ◽  
Hiatal Hernia Repair ◽  
Gerd Symptoms

Introduction Obesity is associated with a higher prevalence of various comorbidities including gastroesophageal reflux disease. It is yet still unclear whether LSG exacerbates or alleviates GERD symptoms. Available date in the literature on LSG influence on GERD are contradictory. Material and methods Systematic review of literature comparing GERD in sleeve gastrectomy versus sleeve gastrectomy with concomtitant hiatal repair. The review was conducted in January 2021 in accordance to PRISMA guidelines. Inclusion criteria involved reporting GERD and comparison of above mentioned techniques. Primary outcome of interest were alleviation of GERD and “de-novo” GERD symptoms. Secondary outcomes were operative time and morbidity. Results Initial search yielded 831 records. After the review and full-text screening 5 studies were included in the analysis. There were no differences in terms of GERD outcomes, p=0.74 for alleviation, p=0.77 for new symptoms. Concomitant hiatal hernia repair significantly prolongs sleeve gastrectomy by 38 mins. Conclusion There are no differences in GERD between hiatal hernia repair during sleeve gastrectomy in comparison to sleeve gastrectomy alone. More high-quality studies are required to fully evaluate this subject.

PS01.048: LAPAROSCOPIC ANTIREFLUX SURGERY IN MORBIDLY OBESE PATIENTS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 63-63
Author(s):  
Marcin Migaczewski ◽  
Mateusz Rubinkiewicz ◽  
Michał Pędziwiatr ◽  
Piotr Major ◽  
Jadwiga Dworak ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
De Novo ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Gerd Symptoms ◽  
Crural Repair

Abstract Background Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been proved to be effective bariatric procedure for the treatment of morbidly obese patients with gastroesophageal reflux disease (GERD). In contrast, the indication for laparoscopic sleeve gastrectomy (LSG) in these group of patients is still not clear. LSG with simultaneous crural repair it can be a new, safe and effective therapautic approach. Methods A total of 60 obese patients with GERD operated on in 2016–2018 were included in the study. 20 patients were qualified for LRYBG. In the rest LSG was performed, of which half with simultaneous crural repair. Results GERD symptoms complete control was observed in 18/20 (90%) patients after LRYGB and 17/20 (85%) after LSG with simultaneous crural repair. The same effect occurred only in 8/20 patients direct after simple LSG. ‘De novo’ GERD symptoms developed in 10% of the patients undergoing alone LSG during 12 months follow up. Conclusion Laparoscopic Roux-en-Y gastric bypass (LRYGB) is still effective bariatric procedure for the treatment of morbidly obese patients with gastroesophageal reflux disease (GERD). Doubts remain in the situation of young patients without diabetes. If we additionally deal with a large hiatal hernia, the qualification for LRYGB remains debatable. In this situation, it is worth considering LSG. Simple sleeve gastrectomy not only does not guarantee a good anti-reflux effect, but it can also produce de-novo GERD. Laparoscopic simultanous crurolasty in the time of LSG, represents a valuable option for the treatment of morbid obesity with gastroesophageal reflux disease Disclosure All authors have declared no conflicts of interest.

EP.TH.239Outcomes and Complications After Sleeve Gastrectomy

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Sima Al Asad ◽  
Shujhat Khan
Keyword(s):  
Type 2 Diabetes ◽  
Sleeve Gastrectomy ◽  
Healthy Lifestyle ◽  
Beneficial Effects ◽  
Positive Effects ◽  
Ovid Medline ◽  
Mesh Terms ◽  
Early Implementation ◽  
Patients Experience

Abstract Aim The sleeve gastrectomy (SG) is a popular bariatric procedure that has beneficial effects that go beyond that of simply reducing obesity. It also has positive effects on diabetes, dyslipidaemia, and hypertension. Method The literature search was carried out using Ovid MEDLINE and PubMed databases to search for keywords and MeSH terms including “bariatric surgery”, “sleeve gastrectomy”, “complications”, “hypertension”, “diabetes”, “dyslipidaemia”, “cardiovascular” and “obesity”. Result SG leads to improvement in hypertension, type 2 diabetes, increased HDL levels, and reduction in uraemia levels that were present even after 10 years. Approximately 56-59% of patients experience type 2 diabetes mellitus remission after a year following a SG operation, and the beneficial effects of the operation on diabetes continue long after a year, with 84-86% of patients noting remission after a 5-year period. Approximately 78.5% who undergo SG will see improvements in hypertension, whilst 67.1% will report resolution. On the other hand, complications include formation of strictures (0.7-4% in patients), haemorrhage (1.5% of patients), and leakage (1.5-2.4%). Additional complications include alteration to bile flow, disruption to microbiota, and disruption to vagus nerve activity. Conclusion Complications from SG are uncommon but can be severe, and the involved mechanisms are only partially revealed. However, optimisation of risk factors in the months leading up to the operation can significantly improve outcomes in patients. This involves an early implementation of a healthy lifestyle including advising patients to exercise more regularly and adopt a low fat, low salt diet, limiting alcohol, and cessation of smoking.

Characteristics of the Frequency-Following Response to Speech in Neonates and Potential Applicability in Clinical Practice: A Systematic Review

2020 ◽  
Vol 63 (5) ◽  
pp. 1618-1635
Author(s):  
Céline Richard ◽  
Mary Lauren Neel ◽  
Arnaud Jeanvoine ◽  
Sharon Mc Connell ◽  
Alison Gehred ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cochrane Library ◽  
Neurodevelopmental Outcomes ◽  
Frequency Following Response ◽  
Ovid Medline ◽  
Published Evidence ◽  
Mesh Terms ◽  
Potential Applicability ◽  
Clinical Potential

Purpose We sought to critically analyze and evaluate published evidence regarding feasibility and clinical potential for predicting neurodevelopmental outcomes of the frequency-following responses (FFRs) to speech recordings in neonates (birth to 28 days). Method A systematic search of MeSH terms in the Cumulative Index to Nursing and Allied HealthLiterature, Embase, Google Scholar, Ovid Medline (R) and E-Pub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Web of Science, SCOPUS, COCHRANE Library, and ClinicalTrials.gov was performed. Manual review of all items identified in the search was performed by two independent reviewers. Articles were evaluated based on the level of methodological quality and evidence according to the RTI item bank. Results Seven articles met inclusion criteria. None of the included studies reported neurodevelopmental outcomes past 3 months of age. Quality of the evidence ranged from moderate to high. Protocol variations were frequent. Conclusions Based on this systematic review, the FFR to speech can capture both temporal and spectral acoustic features in neonates. It can accurately be recorded in a fast and easy manner at the infant's bedside. However, at this time, further studies are needed to identify and validate which FFR features could be incorporated as an addition to standard evaluation of infant sound processing evaluation in subcortico-cortical networks. This review identifies the need for further research focused on identifying specific features of the neonatal FFRs, those with predictive value for early childhood outcomes to help guide targeted early speech and hearing interventions.

scholarly journals The association between gastro-oesophageal reflux disease and subsequent rheumatoid arthritis occurrence: a nested case–control study from Taiwan

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e016667 ◽  
Author(s):  
Herng-Ching Lin ◽  
Sudha Xirasagar ◽  
Cha-Ze Lee ◽  
Chung-Chien Huang ◽  
Chao-Hung Chen
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Diagnosis ◽  
Reflux Disease ◽  
Treatment Guidelines ◽  
Population Based ◽  
Oesophageal Reflux ◽  
Study Patient ◽  
Oesophageal Reflux Disease ◽  
Increased Risk

ObjectiveGastro-oesophageal reflux disease (GORD) is a common comorbidity among patients with rheumatoid arthritis (RA). While GORD has been attributed to the antirheumatic medications, no studies of human cohorts have investigated a link between GORD and RA. This study investigates whether GORD is associated with a subsequent RA diagnosis over a 5-year follow-up using a population-based dataset.SettingTaiwanParticipantsWe used data from the Taiwan Longitudinal Health Insurance Database. The study group consisted of 13 645 patients with an ambulatory claim showing a GORD diagnosis. We used propensity score matching to select 13 645 comparison patients (one per study patient with GORD).InterventionWe tracked each patient’s claims over a 5-year period to identify those who subsequently received a diagnosis of RA. Cox proportional hazard (PH) regression modelling was used for analysis.ResultsOver 5-year follow-up, RA incidence rate per 1000 person-years was 2.81 among patients with GORD and 0.84 among the comparison group. Cox PH modelling showed that GORD was independently associated with a 2.84-fold increased risk of RA (95% CI 2.09 to 3.85) over 5-year follow-up, after adjusting for the number of ambulatory care visits within the year following the index date (to mitigate surveillance bias).ConclusionsWe observed that GORD might associate with subsequent RA occurrence. Because current treatment guidelines for RA emphasise early diagnosis and prompt treatment, the observed association between GORD and RA may help acquaint clinicians to patients with GORD with higher RA risk and facilitate early diagnosis and treatment.

scholarly journals Surgical treatment of recalcitrant gastroesophageal reflux disease in patients with systemic sclerosis: a systematic review

2021 ◽  
Author(s):  
Alberto Aiolfi ◽  
Mario Nosotti ◽  
Kazuhide Matsushima ◽  
Carolina Perali ◽  
Cristina Ogliari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systemic Sclerosis ◽  
Surgical Treatment ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Current Data ◽  
Current Evidence ◽  
Increased Risk

Abstract Introduction Gastroesophageal reflux disease (GERD) is frequently seen in patients with systemic sclerosis (SSc). Long-standing GERD may cause esophagitis, long-segment strictures, and Barrett’s esophagus and may worsen pre-existing pulmonary fibrosis with an increased risk of end-stage lung disease. Surgical treatment of recalcitrant GERD remains controversial. The purpose of this systematic review was to summarize the current data on surgical treatment of recalcitrant GERD in SSc patients. Materials and methods A systematic literature review according to PRISMA and MOOSE guidelines. PubMed, EMBASE, and Web of Science databases were consulted. Results A total of 101 patients were included from 7 studies. The age ranged from 34 to 61 years and the majority were females (73.5%). Commonly reported symptoms were heartburn (92%), regurgitation (77%), and dysphagia (74%). Concurrent pulmonary disease was diagnosed in 58% of patients. Overall, 63 patients (62.4%) underwent open fundoplication, 17 (16.8%) laparoscopic fundoplication, 15 (14.9%) Roux en-Y gastric bypass (RYGB), and 6 (5.9%) esophagectomy. The postoperative follow-up ranged from 12 to 65 months. Recurrent symptoms were described in up to 70% and 30% of patients undergoing fundoplication and RYGB, respectively. Various symptoms were reported postoperatively depending on the type of surgical procedures, anatomy of the valve, need for esophageal lengthening, and follow-up. Conclusions The treatment of recalcitrant GERD in SSc patients is challenging. Esophagectomy should be reserved to selected patients. Minimally invasive RYGB appears feasible and safe with promising preliminary short-term results. Current evidence is scarce while a definitive indication about the most appropriate surgical treatment is lacking.

scholarly journals Metabolic syndrome and insulin resistance in pre-pubertal children with psoriasis

2021 ◽  
Author(s):  
Francesca Caroppo ◽  
Alfonso Galderisi ◽  
Laura Ventura ◽  
Anna Belloni Fortina
Keyword(s):  
Metabolic Disease ◽  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Model Assessment ◽  
Limited Data ◽  
Single Center ◽  
Increased Risk ◽  
High Prevalence ◽  
Homeostatic Model Assessment ◽  
Homeostatic Model

AbstractPsoriasis in adults is associated with an increased risk of metabolic disease. Various cardiometabolic comorbidities have been reported in childhood psoriasis, but only a few studies have analyzed the prevalence of metabolic syndrome. We performed a single-center prospective study investigating the prevalence of metabolic syndrome and insulin resistance in children with psoriasis. The prevalence of metabolic syndrome was evaluated in 60 pre-pubertal children with psoriasis (age: 3–10 years), accordingly to recently established criteria for the diagnosis of metabolic syndrome in children. Insulin resistance was considered altered when the homeostatic model assessment (HOMA-IR) for insulin resistance was ≥ 90th sex- and age-specific percentile and HOMA 2-IR was > 1.8. Eighteen (30%) children with psoriasis were found to have metabolic syndrome. Sixteen (27%) children were found to have insulin resistance.Conclusion: Our data underline the importance of assessing metabolic syndrome not only in adults and adolescents but also in young children with psoriasis. What is Known:• Psoriasis in adults is strongly associated with metabolic disease and insulin resistance.• Very limited data are available on the prevalence of metabolic syndrome and insulin resistance in pre-pubertal children with psoriasis. What is New:• This study reports that in pre-pubertal children with psoriasis, there is a high prevalence of metabolic syndrome and insulin resistance.• In children with psoriasis metabolic syndrome risk factors should be assessed.

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