Alfredo casella score pdf download11/8/2022 ![]() ![]() Predictive factors of evolution or appearance of gastroesophageal reflux disease (GERD) after sleeve gastrectomy (SG) have not been identified to date. However, further studies based on objective assessment are warranted to evaluate these results better. SG+HHR seems to have a promising future in patients with obesity and GERD. However, there was no significant difference in de novo GERD after SG+HHR compared with SG alone.ConclusionsSG+HHR can positively affect weight loss, GERD resolution, esophagitis reduction, and GERD-HRQL improvement. Web of Science, PubMed, Embase, the Cochrane Library, and databases were searched for all studies reporting the efficacy of SG+HHR for patients with obesity and GERD up to March 2021.ResultsA total of 18 studies totaling 937 patients met the inclusion criteria. To evaluate the effect of concomitant SG and HHR on GERD in patients with obesity.Methods However, its effect on gastroesophageal reflux disease (GERD) remains controversial.Objective Hiatal hernia repair (HHR) during sleeve gastrectomy (SG) is recommended when hiatal hernia (HH) is found intraoperatively. Moreover, we propose a diagnostic algorithm for preoperative GERD assessment, which includes validated symptom questionnaires, upper gastrointestinal endoscopy, APM, and HRM. In this review, we evaluate the current literature concerning the use of APM and HRM in the diagnostic pathway before SG, as well as their predictive value for the evolution of GERD in the postoperative course. Ambulatory pH monitoring (APM) and high-resolution manometry (HRM) are useful diagnostic tools that could provide valuable evidence in the guidance of surgical strategy. For these reasons, the reflux burden and the competence of the anti-reflux barrier should be carefully assessed during the preoperative work-up of patients undergoing SG. Moreover, patients with preoperative s-GERD have a significantly higher risk of experiencing GERD symptoms after SG. ![]() In fact, a high rate of silent GERD (s-GERD, asymptomatic patients despite objective evidence of GERD) has been reported. In patients with severe obesity, a strictly symptom-based diagnosis of GERD is unreliable. To date, there is great heterogeneity concerning the definition of GERD, the indication for SG in patients with GERD, and the standardization of pre and postoperative diagnostic pathways. However, the postoperative development or worsening of gastroesophageal reflux disease (GERD) is one of the most important drawbacks of this surgical procedure. Laparoscopic sleeve gastrectomy (SG) has reached wide popularity during the last 15 years, owing to limited morbidity and mortality rates, very successful weight loss results, and impact on comorbidities. ![]()
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