scholarly journals Outcomes of laparoscopic sleeve gastrectomy by means of esophageal manometry and pH-metry, before and after surgery

2020 ◽  
Vol 15 (1) ◽  
pp. 129-135
Author(s):  
Eyup Gemici ◽  
Osman Kones ◽  
Hakan Seyit ◽  
Ahmet Surek ◽  
Murat Cikot ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Esophageal Manometry ◽  
Before And After ◽  
Ph Metry

scholarly journals Manometric and pH-monitoring changes after laparoscopic sleeve gastrectomy: a systematic review

2021 ◽  
Author(s):  
Andrea Balla ◽  
Francesca Meoli ◽  
Livia Palmieri ◽  
Diletta Corallino ◽  
Maria Carlotta Sacchi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
De Novo ◽  
Ph Monitoring ◽  
Meta Analysis ◽  
Acid Exposure ◽  
Demeester Score ◽  
Before And After ◽  
Ph Metry

Abstract Purpose Aim of this systematic review is to assess the changes in esophageal motility and acid exposure of the esophagus through esophageal manometry and 24-hours pH-monitoring before and after laparoscopic sleeve gastrectomy (LSG). Methods Articles in which all patients included underwent manometry and/or 24-hours pH-metry or both, before and after LSG, were included. The search was carried out in the PubMed, Embase, Cochrane, and Web of Science databases, revealing overall 13,769 articles. Of these, 9702 were eliminated because they have been found more than once between the searches. Of the remaining 4067 articles, further 4030 were excluded after screening the title and abstract because they did not meet the inclusion criteria. Thirty-seven articles were fully analyzed, and of these, 21 further articles were excluded, finally including 16 articles. Results Fourteen and twelve studies reported manometric and pH-metric data from 402 and 547 patients, respectively. At manometry, a decrease of the lower esophageal sphincter resting pressure after surgery was observed in six articles. At 24-hours pH-metry, a worsening of the DeMeester score and/or of the acid exposure time was observed in nine articles and the de novo gastroesophageal reflux disease (GERD) rate that ranged between 17.8 and 69%. A meta-analysis was not performed due to the heterogeneity of data. Conclusions After LSG a worsening of GERD evaluated by instrumental exams was observed such as high prevalence of de novo GERD. However, to understand the clinical impact of LSG and the burden of GERD over time further long-term studies are necessary.

Changes in the gut microbiota of morbidly obese patients after laparoscopic sleeve gastrectomy

2021 ◽  
Author(s):  
Alev Kural ◽  
Imran Khan ◽  
Hakan Seyit ◽  
Tuba R Caglar ◽  
Pınar Toklu ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Gut Microbiota ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Amplicon Sequencing ◽  
Morbidly Obese ◽  
Microbiota Composition ◽  
16S Amplicon Sequencing ◽  
Before And After ◽  
Stool Samples ◽  
Gut Microbiota Composition

Aims: Permanent treatment of morbid obesity with medication or diet is nearly impossible. Laparoscopic sleeve gastrectomy (LSG) is becoming a widely accepted treatment option. This study profiled and compared gut microbiota composition before and after LSG. Methods & results: A total of 54 stool samples were collected from 27 morbidly obese individuals before and after LSG. The gut microbiota was profiled with 16S amplicon sequencing. After LSG, patients demonstrated a significant decrease (p < 0.001) in BMI and an increase in bacterial diversity. An increased Firmicutes/Bacteroidetes ratio was also noticed after LSG. The families Prevotellaceae and Veillonellaceae predominated in preoperative samples but were markedly lowered after LSG. A marked increase in Akkermansia, Alistipes, Streptococcus, Ruminococcus and Parabacteroides was observed after LSG. Conclusion: In addition to lowering BMI, LSG remodeled gut microbiota composition.

scholarly journals Laparoscopic Removal of Angelchik Prosthesis Followed by Interval Sleeve Gastrectomy

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Faryal G. Afridi ◽  
Morgan Johnson ◽  
Kelsey A. Musgrove ◽  
Salim Abunnaja ◽  
Lawrence E. Tabone ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Esophageal Motility ◽  
Esophageal Manometry ◽  
Gastroesophageal Junction ◽  
Antireflux Procedure ◽  
Bariatric Clinic ◽  
Work Up ◽  
Laparoscopic Removal

Introduction. The Angelchik prosthesis (AP) is a historic antireflux device which consists of a C-shaped silicone ring placed around the gastroesophageal junction (GEJ) and secured by Dacron tape. We present a rare experience with an AP and its impact on bariatric surgical outcomes. Case. Our patient is a 66-year-old woman who had an open antireflux procedure with an AP in 1987. She presented to a bariatric clinic for consideration of bariatric surgery for the treatment of morbid obesity and associated comorbidities. She also reported significant problems with reflux and dysphagia. After an appropriate work-up, an AP was identified at her GEJ. She was taken to the operating room for laparoscopic removal with planned interval laparoscopic sleeve gastrectomy. Intraoperatively, the AP was identified around the GEJ; after extensive adhesiolysis, the prosthesis was removed. Postoperatively, in order to determine if the AP had caused any lasting esophageal motility problems, the patient underwent a high-resolution esophageal manometry which demonstrated normal esophageal motility. Interval laparoscopic sleeve gastrectomy was performed safely 9 weeks later. Conclusion. Although rarely used, it is still possible to encounter an Angelchik prosthesis in practice. General and bariatric surgeons need to be aware of this rare device and understand how to manage its related complications.

Rates of Reflux Before and After Laparoscopic Sleeve Gastrectomy for Severe Obesity

2014 ◽  
Vol 25 (5) ◽  
pp. 763-768 ◽  
Author(s):  
Caroline E. Sheppard ◽  
Daniel C. Sadowski ◽  
Christopher J. de Gara ◽  
Shahzeer Karmali ◽  
Daniel W. Birch
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Severe Obesity ◽  
Before And After

pH monitoring of gastro-oesophageal reflux before and after laparoscopic sleeve gastrectomy

2016 ◽  
Vol 103 (4) ◽  
pp. 399-406 ◽  
Author(s):  
J. Thereaux ◽  
C. Barsamian ◽  
M. Bretault ◽  
H. Dusaussoy ◽  
D. Lamarque ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Ph Monitoring ◽  
Oesophageal Reflux ◽  
Before And After

scholarly journals Nutritional assessment of obese patients before and after laparoscopic sleeve gastrectomy (LSG)

2016 ◽  
Vol 13 ◽  
pp. e74
Author(s):  
Ilektra Fotopoulou ◽  
Konstantina Κonstantinou ◽  
Anastasia Markaki ◽  
Ioannis Melissas
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Nutritional Assessment ◽  
Obese Patients ◽  
Before And After

scholarly journals Impact of Laparoscopic Sleeve Gastrectomy on Esophageal Physiology

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Andrada-Loredana Popescu ◽  
Florentina Ioniţa-Radu ◽  
Mariana Jinga ◽  
Vasile-Daniel Balaban ◽  
Raluca-Simona Costache ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
High Resolution ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Lower Esophageal Sphincter ◽  
Esophageal Manometry ◽  
Morbidly Obese ◽  
Esophageal Physiology ◽  
Esophageal Sphincter ◽  
The Impact

Abstract Introduction: Laparoscopic sleeve gastrectomy (LSG) is a popular weight loss surgery technique, but the impact on esophageal physiology and esophagogastric junction is still debatable. The aim of our study was to evaluate the manometric changes of the lower esophageal sphincter (LES) after LSG in order to indicate LES manometry pre- procedure. Methods: In a prospective study we evaluated clinically, with upper gastrointestinal endoscopy, and high-resolution esophageal manometry 45 morbidly obese patients before, and 6-12 months after LSG. Results: The BMI (body mass index) decreased from 46.28±5.79 kg/m2 to 32.28±4.65 kg/m2 postoperatively (p <0.01), with a reduction of ~14 kg/m2 of BMI, 39.9 (±11.9) kg body weight and 29.9 (± 6.2)% of the TWL (Total Weight Loss index), in a median interval of 7.9 months. Gastroesophageal reflux disease (GERD) prevalence increased from 17.8% to 31.1% postoperatively, with new GERD onset in 22.2%, but mild symptomatology (the median GERDHRQL score increased from 1.56 to 2.84 points). Postoperatory reflux was associated with lower esophageal sphincter (LES) hypotonia, shortening of LES length and IIGP (increased intragastric pressure). Hiatal hernia repair rate was 17.8%, and proton pump inhibitor consumption 20%. After weight loss, the 10 cases of esophagitis discovered preoperatively cured, but 3 patients were diagnosed with de novo esophagitis. The prevalence of manometric dysmotility after LSG was 28.9%, lower than before surgery (44.4%). Conclusion: Even if GERD remains the main limitation of LSG, the high-resolution esophageal manometry has proved useful and should be implemented in morbidly obese evaluation protocol, to better select the bariatric procedure.

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