Can lower preoperative 48-hour pH score predict reflux resolution after sleeve gastrectomy

Area of Science:

• Gastroenterology
• Bariatric Surgery
• Obesity Medicine

Background:

• Gastroesophageal reflux disease (GERD) is a common comorbidity in morbidly obese patients.
• Sleeve gastrectomy (SG) is a bariatric procedure that can impact GERD.
• Reflux resolution varies among patients post-SG.

Purpose of the Study:

• To identify factors associated with the resolution of reflux after sleeve gastrectomy in morbidly obese patients.
• To evaluate the predictive value of pre-operative parameters on post-operative reflux status.

Main Methods:

• A cohort of 70 morbidly obese patients undergoing SG for reflux were evaluated.
• Baseline weight, body mass index (BMI), and DeMeester score (DMS) were assessed pre-operatively.
• Resolution of reflux post-operatively was the primary outcome measure.

Main Results:

• 47.1% of patients experienced reflux resolution (RR group), while 52.9% did not (NR group).
• Pre-operative weight, BMI, percent excess BMI loss, and presence of a small hiatal hernia (≤2 cm) were similar between groups.
• Male gender and lower pre-operative DeMeester scores were significantly associated with reflux resolution (p=0.03).

Conclusions:

• A lower pre-operative DeMeester score may indicate a higher likelihood of reflux resolution following sleeve gastrectomy.
• Sleeve gastrectomy may be a viable option for morbidly obese patients with reflux, even with a small hiatal hernia.
• The DeMeester score alone is insufficient to predict reflux resolution; other factors should be considered.