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.
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.
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.
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.