Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022
The Hill's Classification Is Useful to Predict the Development of Postoperative Gastroesophageal Reflux Disease and Erosive Esophagitis After Laparoscopic Sleeve Gastrectomy.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Chue Koy Min, Goh Daniel Wen Xiang, Chua Cheryl Min En, Toh Bin Chet, Ong Lester Wei Lin, Wong Wai Keong, Lim Chin Hong, Tan Jeremy Tian Hui, Yeung Baldwin Po Man
Аннотация
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is one of the commonest bariatric procedures. However, it is associated with postoperative gastroesophageal reflux disease (GERD) and erosive esophagitis (EE). This study aims to assess the impact of various preoperative clinical and endoscopic characteristics on the development of postoperative GERD and EE.
METHODS: This study is a single-institution retrospective cohort study involving all patients who underwent LSG. A univariate and multivariate analysis was performed to identify preoperative parameters that were significantly associated with the development of postoperative GERD and EE, at up to 1-year follow-up.
RESULTS: At up to 1-year follow-up, out of 127 patients, only preoperative endoscopic presence of a hiatal hernia noted on axial length (p=0.024) and the Hill's classification of the gastroesophageal junction (p<0.001) were significantly associated with the development of postoperative GERD. Similarly, at 1-year follow-up endoscopy, the presence of a hiatal hernia (p=0.041) and the Hill's classification (p=0.001) were associated with postoperative EE. On the multivariate analysis, compared to patients with a Hill's I flap valve, Hill's II patients were more likely to develop postoperative GERD (OR 7.13, 95% CI: 1.69-29.98, p=0.007), and Hill's III patients were more likely to develop postoperative GERD (OR 20.84, 95% CI: 3.98-109.13, p<0.001) and EE (OR 34.49, 95% CI: 1.08-1105.36, p=0.045). All patients with Hill's IV developed postoperative GERD and EE in this study.
CONCLUSION: Postoperative GERD and EE remain an important limitation following LSG. Proper preoperative assessment using the Hill's classification can help to accurately predict patients at risk of postoperative GERD and EE.
METHODS: This study is a single-institution retrospective cohort study involving all patients who underwent LSG. A univariate and multivariate analysis was performed to identify preoperative parameters that were significantly associated with the development of postoperative GERD and EE, at up to 1-year follow-up.
RESULTS: At up to 1-year follow-up, out of 127 patients, only preoperative endoscopic presence of a hiatal hernia noted on axial length (p=0.024) and the Hill's classification of the gastroesophageal junction (p<0.001) were significantly associated with the development of postoperative GERD. Similarly, at 1-year follow-up endoscopy, the presence of a hiatal hernia (p=0.041) and the Hill's classification (p=0.001) were associated with postoperative EE. On the multivariate analysis, compared to patients with a Hill's I flap valve, Hill's II patients were more likely to develop postoperative GERD (OR 7.13, 95% CI: 1.69-29.98, p=0.007), and Hill's III patients were more likely to develop postoperative GERD (OR 20.84, 95% CI: 3.98-109.13, p<0.001) and EE (OR 34.49, 95% CI: 1.08-1105.36, p=0.045). All patients with Hill's IV developed postoperative GERD and EE in this study.
CONCLUSION: Postoperative GERD and EE remain an important limitation following LSG. Proper preoperative assessment using the Hill's classification can help to accurately predict patients at risk of postoperative GERD and EE.