XXXX in laparoscopic sleeve gastrectomy: hiatal findings and their management influence outcome.

@entity1 @entity28 @entity7080 @entity425 @entity357 @entity354
BACKGROUND: Sleeve gastrectomy (SG) has become a definitive treatment for morbid @entity28 . There is conflicting evidence on the effects of SG on @entity354 ( @entity354 ). OBJECTIVE: The objective of this study was to assess whether taking an aggressive approach to managing @entity425 in @entity1 undergoing SG results in an alteration in @entity354 symptoms. SETTING: Tertiary public hospital and private hospital, Sydney, Australia. METHODS: @entity1 undergoing laparoscopic extended (beginning within 2 cm from pylorus) SG were included. If evidence of @entity425 was present, an anterior hiatal dissection and tight suture repair was performed. If a @entity357 was present, formal repair was undertaken. @entity1 were questioned and scored on preoperative and postoperative reflux symptom frequency and severity, @entity7080 inhibitor (PPI) usage, current weight, and satisfaction. RESULTS: A continuous cohort of 262 @entity1 experienced a significant reduction in heartburn frequency (P = .035) and severity (P = .017). Moderate/severe preoperative reflux (Visick score 3 and 4) often improved whether there was a defect requiring repair or not (no repair P = .02, hiatal suture P = .001, @entity357 repair P<.001). The severity of symptoms also improved (no repair P = 0.005, hiatal suture P<.001, @entity357 repair P< .001). CONCLUSION: Moderate or severe preexisting @entity354 improved for most of our @entity28 @entity1 undergoing an extended SG when hiatal defects were routinely repaired. Moderate to severe preoperative reflux also improved in the average @entity28 @entity1 when there was no hiatal defect to repair.
