Intrathoracic Sleeve Migration Following Sleeve Gastrectomy: Incidence and Outcomes

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Radiology

Background:

• Laparoscopic sleeve gastrectomy (LSG) is a leading bariatric procedure.
• Gastroesophageal reflux disease (GERD) is a common complication post-LSG.
• Intrathoracic migration (ITM) of the gastric sleeve is an underrecognized cause of GERD.

Purpose of the Study:

• To determine the incidence of spontaneous ITM after LSG.
• To investigate the relationship between ITM and patient characteristics.
• To analyze the association of ITM with perioperative outcomes and GERD severity.

Main Methods:

• Retrospective review of 206 patients undergoing LSG.
• Annual follow-up with non-enhanced CT scans and esophagogastroduodenoscopy (EGD).
• Comparison of baseline characteristics and clinical outcomes between ITM and no-ITM groups.

Main Results:

• The incidence of ITM was 14% (29/206 patients).
• ITM significantly correlated with postoperative reflux symptoms (p=0.001).
• Patients with ITM required longer anti-reflux medication use and had higher rates of esophagitis on EGD (p=0.002).

Conclusions:

• The incidence of ITM after LSG is 14%.
• ITM is significantly associated with clinical GERD and esophagitis.
• ITM is a critical factor to consider in managing GERD post-LSG.