Incidence of Abnormalities of the Gastric Tube Following Sleeve Gastrectomy and Its Role on Esophagitis Progression

• Published in: Obesity surgery Vol. 33; no. 1; pp. 263 - 267
• Main Authors: da Silva, José-Tarcísio Dias, Santa-Cruz, Fernando, Cavalcanti, Joyce Maria S., Padilha, Marina Viana, Coutinho, Lucas R., Siqueira, Luciana T., Ferraz, Álvaro A. B.
• Format: Journal Article
• Language: English
• Published: New York Springer US 2023; Springer Nature B.V
• Subjects: Adult; Esophagitis - epidemiology; Esophagitis - etiology; Esophagitis - surgery; Female; Gastrectomy - adverse effects; Gastroesophageal Reflux - etiology; Hernia, Hiatal - surgery; Hiatal hernias; Humans; Incidence; Laparoscopy - adverse effects; Male; Medicine; Medicine & Public Health; Obesity, Morbid - surgery; Original Contributions; Retrospective Studies; Surgery; Gastric volvulus; Hiatal hernia; Gastroesophageal reflux disease; Esophagitis; Gastric fundus; Stomach dilation; Sleeve gastrectomy
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-022-06375-4

Purpose The purpose of this study is to determine the incidence of gastric tube abnormalities after SG and its relationship with esophagitis progression. Methods Retrospective study which included 459 patients in the postoperative period of SG who underwent an esophagogastroduodenoscopy in both pre- and postoperative periods. The main studied variables were presence of gastric tube abnormalities (dilation, neofundus, twist, and hiatal hernia) and esophagitis progression. Results Among the 459 patients who underwent SG, 393 (85.6%) were women, and 66 (14.4%) men, with mean age of 40.4 years. Mean preoperative BMI was 39.70 kg/m 2 . In total, 20.3% of the sample presented progression of esophagitis after surgery. Among the whole sample, 130 (28.3%) presented with an abnormality of the remnant gastric tube. The most common alteration was gastric dilation, which occurred in 16.1% of the patients, followed by gastric twist (10.7%), neofundus (7.4%), and hiatal hernia (0.2%). Patients who presented with any abnormality of the gastric tube were significantly prone to presenting esophagitis progression ( p  = 0.013). When analyzing each morphological abnormality isolated, there was no statistically significant correlation. Conclusion Abnormalities of the gastric tube are not uncommon after SG and seems to contribute partially to the relevant rates of GERD and esophagitis after this surgery. Graphical Abstract