Background

Sleeve gastrectomy (SG) patients often present with gastroesophageal reflux (GERD) symptoms postoperatively. Our aim was to evaluate factors that impact GERD recidivism or de novo after SG.

Methods

A single-institution retrospective review was performed for patients undergoing laparoscopic primary SG during 2014-2016. Demographics, intraoperative data and long-term percent of excess weight loss (%EWL) were assessed. Callbacks were performed to evaluate GERD symptoms preoperatively and at long-term. Logistic regression was performed for postoperative symptoms improvement or de novo GERD for the variables of age, preoperative BMI, hiatal hernia repair (HHR) and %EWL at long-term, using SPSS v25.0, α=0.05.

Results

49 patients were included. Majority were female (81.6%), Caucasian (95.5%) with a mean age of 54±11.5 years and mean preoperative BMI 45.6±7.59kg/m2. Preexisting comorbidities were hypertension (69.4%), OSA (63.6%), dyslipidemia (42.9%), and diabetes (35%). Median follow-up was 3 years [1-10 years]. Although not statistically significant, 92.3% of patients who developed de novo GERD had a preoperative BMI>40kg/m2. 36.4% of patients with starting BMI>50kg/m2 developed de novo GERD versus 9.1% with BMI<40kg/m2, p=0.064. Regression analysis revealed that patients who did not undergo concurrent HHR were 6.8 times more likely to develop de novo GERD at long-term. BMI, age and %EWL at long-term were not independently associated with either resolution of or de novo GERD.

Conclusions

Our preliminary results revealed that concurrent HHR was independently associated with de novo GERD symptoms at long-term after SG. Age, BMI, and long-term %EWL were not associated. This information can help guide patient candidacy for SG.