@article{10.11648/j.js.20160405.14,
  author = {Mosaad Mahmoud Morshed and Mohamed Anwar Abdel-Razik and Sabry Ahmed Ahmed Mahmoud and Alaa Magdy Abou El-Fotouh and Sameh Hany Emile and Hosam Ghazy Elbanna and Mohamed Youssef and Emad Abdallah and Nabil Ali Gad El-Hak},
  title = {Functional Assessment of the Esophagogastric Junction After Laparoscopic Sleeve Gastrectomy},
  journal = {Journal of Surgery},
  volume = {4},
  number = {5},
  pages = {105-113},
  doi = {10.11648/j.js.20160405.14},
  url = {https://doi.org/10.11648/j.js.20160405.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20160405.14},
  abstract = {The relation between bariatric procedures and gastroesophageal reflux disease (GERD) seems to be quite complex and unclear. The present trial aimed to assess the functional changes that occur in the esophagogastric junction (EGJ) after laparoscopic sleeve gastrectomy (LSG) using objective methods for assessment as esophageal manometry and ambulatory 24-hour pH monitoring in attempt to correlate these changes with either the deterioration or the alleviation of GERD symptoms after LSG. This prospective case series study was conducted on patients with morbid obesity who were treated with LSG in the General Surgery Department, Mansoura University Hospitals. All patients were assessed pre- and postoperatively for the presence of GERD both clinically and with esophagogastrodudenoscopy (EGD). Functional assessment of the EGJ was done before LSG and at six months of follow-up using esophageal manometry and ambulatory 24-hour esophageal pH monitoring. Twenty morbidly obese patients (16 females & 4 males) of a mean age of 29.4 years had underwent functional assessement of the EGJ before and at six months after LSG. The mean BMI at the time of surgery was 51.6 ± 8.7 kg/m². Thirteen patients had no symptoms related to GERD preoperatively, all of these patients remained symptom-free after LSG. Seven (35%) patients had preoperative symptoms of GERD, three reported no change in their symptoms at six months of follow-up, and four reported significant improvement of their symptoms six months after LSG. Overall, no significant changes in the manometric parameters were noticed. However, a significant decrease in the resting LES pressure was noticed after LSG in patients with no preoperative GERD symptoms, but not in patients with symptomatic GERD. Seven (35%) patients had high preoperative DeMeester scores and prolonged total acid reflux time percentage, all of them got normalized postoperatively except two patients. Absolute concordance of the four parameters studied was observed in seven (35%) patients only. Esophageal manometry has a limited utility in the detection or exclusion of GERD postoperatively since the significant decrease in the resting LES pressure observed was not associated with symptoms of GERD. On the other hand, 24-hour pH monitoring was able to detect improvement or persistence of GERD in the patients studied.},
 year = {2016}
}

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TY  - JOUR
T1  - Functional Assessment of the Esophagogastric Junction After Laparoscopic Sleeve Gastrectomy
AU  - Mosaad Mahmoud Morshed
AU  - Mohamed Anwar Abdel-Razik
AU  - Sabry Ahmed Ahmed Mahmoud
AU  - Alaa Magdy Abou El-Fotouh
AU  - Sameh Hany Emile
AU  - Hosam Ghazy Elbanna
AU  - Mohamed Youssef
AU  - Emad Abdallah
AU  - Nabil Ali Gad El-Hak
Y1  - 2016/09/13
PY  - 2016
N1  - https://doi.org/10.11648/j.js.20160405.14
DO  - 10.11648/j.js.20160405.14
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 105
EP  - 113
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20160405.14
AB  - The relation between bariatric procedures and gastroesophageal reflux disease (GERD) seems to be quite complex and unclear. The present trial aimed to assess the functional changes that occur in the esophagogastric junction (EGJ) after laparoscopic sleeve gastrectomy (LSG) using objective methods for assessment as esophageal manometry and ambulatory 24-hour pH monitoring in attempt to correlate these changes with either the deterioration or the alleviation of GERD symptoms after LSG. This prospective case series study was conducted on patients with morbid obesity who were treated with LSG in the General Surgery Department, Mansoura University Hospitals. All patients were assessed pre- and postoperatively for the presence of GERD both clinically and with esophagogastrodudenoscopy (EGD). Functional assessment of the EGJ was done before LSG and at six months of follow-up using esophageal manometry and ambulatory 24-hour esophageal pH monitoring. Twenty morbidly obese patients (16 females & 4 males) of a mean age of 29.4 years had underwent functional assessement of the EGJ before and at six months after LSG. The mean BMI at the time of surgery was 51.6 ± 8.7 kg/m². Thirteen patients had no symptoms related to GERD preoperatively, all of these patients remained symptom-free after LSG. Seven (35%) patients had preoperative symptoms of GERD, three reported no change in their symptoms at six months of follow-up, and four reported significant improvement of their symptoms six months after LSG. Overall, no significant changes in the manometric parameters were noticed. However, a significant decrease in the resting LES pressure was noticed after LSG in patients with no preoperative GERD symptoms, but not in patients with symptomatic GERD. Seven (35%) patients had high preoperative DeMeester scores and prolonged total acid reflux time percentage, all of them got normalized postoperatively except two patients. Absolute concordance of the four parameters studied was observed in seven (35%) patients only. Esophageal manometry has a limited utility in the detection or exclusion of GERD postoperatively since the significant decrease in the resting LES pressure observed was not associated with symptoms of GERD. On the other hand, 24-hour pH monitoring was able to detect improvement or persistence of GERD in the patients studied.
VL  - 4
IS  - 5
ER  - 

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