title: Short-Term Results of Laparoscopic Sleeve Gastrectomy in Combination with Hiatal Hernia Repair: Experience in a Single Accredited Center.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (SG), while generally safe and efficacious, may be complicated by gastroesophageal reflux disease (GERD) symptoms as well as the need for hiatus hernia (HH) repair. Identification and management of HH during SG and the effect of HH repair on GERD-related symptoms following SG are controversial.
  
  
  OBJECTIVE
  This study aimed to evaluate HH repair during SG in morbidly obese patients and its short-term effect on GERD-related symptoms and other clinical outcomes.
  
  
  METHODS
  University Hospital, United States
  
  
  METHODS
  We retrospectively reviewed patients who underwent primary SG and HH repair. Outcomes included operative time, blood loss, postoperative excess weight loss (%EWL), and self-reported GERD symptoms using a health-related quality of life (HRQL) questionnaire.
  
  
  RESULTS
  For a total of 338 patients, 99 patients (29 %) underwent SG in combination with HH repair; 56 patients (16 %) underwent anterior repair of HH (SG + HH), and 43 patients (13 %) underwent posterior repair with or without mesh placement (SG + paraesophageal hernia (PEH)). We found no significant differences in operative time or blood loss, with significantly higher %EWL at 6 months in SG + HH (n = 43) and SG + PEH (n = 32) compared to SG alone (n = 190). There was also a statistically significant improvement in postoperative GERD symptoms. Finally, SG + HH and SG + PEH patients reported greater satisfaction compared to SG patients (>93 versus 87 %).
  
  
  CONCLUSIONS
  SG patients undergoing HH repair experienced higher %EWL, improved GERD symptoms, and greater satisfaction compared to SG alone in the short term. Further studies are needed to clarify long-term outcomes among patients undergoing SG in combination with HH repair.
authors.affiliation: Department of Surgery, Division of Bariatric and Minimally Invasive Surgery, The Medical School of Temple University, St Luke's University and Health Network, 240 Cetronia Road, Suite 205, North Allentown, PA, 18104, USA. Maher.Elchaar@sluhn.org.
authors.forename: Maher
authors.initials: M
authors.lastname: El Chaar
authors.affiliation: Department of Surgery, Division of Bariatric and Minimally Invasive Surgery, The Medical School of Temple University, St Luke's University and Health Network, 240 Cetronia Road, Suite 205, North Allentown, PA, 18104, USA.
authors.forename: George
authors.initials: G
authors.lastname: Ezeji
authors.affiliation: Department of Surgery, Division of Bariatric and Minimally Invasive Surgery, The Medical School of Temple University, St Luke's University and Health Network, 240 Cetronia Road, Suite 205, North Allentown, PA, 18104, USA.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Claros
authors.affiliation: Department of Surgery, Division of Bariatric and Minimally Invasive Surgery, The Medical School of Temple University, St Luke's University and Health Network, 240 Cetronia Road, Suite 205, North Allentown, PA, 18104, USA.
authors.forename: Maureen
authors.initials: M
authors.lastname: Miletics
authors.affiliation: Research Institute and Medical School of Temple University, St. Luke's University Health Network, Allentown, PA, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Stoltzfus
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery; D006551:Hernia, Hiatal / Q000150:complications / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D061646:Operative Time; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Bariatric surgery; Gastroesophageal reflux disease (GERD); Hiatus hernia (HH) repair; Laparoscopic sleeve gastrectomy (SG)