Comparison of Patients with and Without Hiatal Hernia Repair during Laparoscopic Sleeve Gastrectomy: Single-centre Experience

Abstract

Objective: To evaluate whether the concomitant repair of hiatal hernias during laparoscopic sleeve gastrectomy has an effect on the outcome of the surgery in patients with hiatal laxity and gastroesophageal reflux disease (GERD) symptoms during preoperative preparations.

Study design: Descriptive study.

Place and duration of study: Department of General Surgery, Kayseri City Training and Research Hospital, Health Science University, Kayseri, Turkey, from 2016 to 2020.

Methodology: Reflux symptom index questionnaire (RSI) is used in patients with GERD symptoms and in cases where hiatal hernia is detected in routine endoscopy. Preoperative and postoperative periods can be compared with this non-invasive and short-term test.

Results: Thirty-five patients were included in the study. The mean age of the included patients was 36.0 ± 9.8 (range, 21- 54) years, 80% of them were female. The preoperative median BMI was 43.9 (IQR, 41-50.7), and the postoperative mean BMI was 31.3 ± 5.1 (range, 23.2-40.6) Kg/m2. The median calculated RSI of the patients in the preoperative period was 8 (IQR, 2-13), and the postoperative median was 5.1 (IQR, 0-8) (p = 0.028). It was observed that 24 (68.6%) of the patients had improvement in their symptoms, 7 (20%) patients had worsening, 3 (8.6%) patients did not experience a change, and only one (2.9%) patient developed de novo GERD symptoms. Conclusion: No statistically significant difference was observed in individuals undergoing LSG and known to have GERD, hiatal hernia repair and cruroraphy in addition to LSG regarding reduction of GERD symptoms. Key Words: Sleeve gastrectomy, Reflux symptom index score, Gastroesophageal reflux disease.