There is insufficient data on the impact of laparoscopic sleeve gastrectomy (LSG) on gastroesophageal reflux disease (GERD) in published literature.

A study by Moya and colleagues sought to determine the effects of sleeve gastrectomy on GERD among morbidly obese patients. Candidates for LSG underwent barium swallow, esophageal manometry, ambulatory 24-h esophageal pH monitoring (APM), and gastric emptying scintigraphy prior to and 1 and 18 months after surgery. A gastroesophageal reflux disease questionnaire (GERDq) was used to analyze symptoms. Esophagogastroduodenoscopy was done before surgery in all patients and at 18 months after the surgery in patients who had preoperative esophagitis.

The study included a total of 52 patients (64.4% women) with a median age of 46 years (25-63 years) and BMI 45.0 ± 5.6 kg/m². The follow-up rates at 1 and 18 months were 82.7% and 80.8%.

• At 18 months, percentage weight loss (%TWL) was 33.6 ± 10.4% and percentage of excess BMI loss (%EBMIL) was 77.6 ± 25%.
• After the surgery, there was a significant increase in accelerated gastric emptying and impaired esophageal body motility at 1 and 18 months.
• On comparing the results of the APM, a significant worsening of all the values obtained at 1 and 18 months postoperatively was apparent.
• Postoperatively, 76.4% patients developed "de novo" GERD at 1 month and 41% developed it at 18 months.
• There was no improvement in patients with symptomatic GERD.

The researchers concluded that LSG was associated with a considerable rate of postoperative "de novo" GERD. Furthermore, there was no improvement in patients with symptomatic GERD.

Source: Moya CS, Esteban MB, García-Argüelles JS, et al. The Impact of Sleeve Gastrectomy on Gastroesophageal Reflux Disease in Patients with Morbid Obesity. Obes Surg. 2022 Jan 20.