Laparoscopic sleeve gastrectomy and gastroesophageal reflux disease: a systematic review and meta-analysis.
BACKGROUND
The effect of sleeve gastrectomy (SG) on the prevalence of gastroesophageal reflux disease (GERD) remains unclear. We aimed to outline the currently available literature.


METHODS
All relevant databases were searched for publications examining the effect of laparoscopic SG on GERD. Primary outcome measure was change in prevalence of GERD symptoms, antireflux medication use, and esophageal function tests. Secondary outcomes were prevalence of new-onset GERD and esophagitis. Thirty-three articles were included. Eleven studies used questionnaires to assess changes in the prevalence of GERD symptoms, with a risk difference in prevalence of 4.3%. Eight studies used esophageal function tests, with paradoxical results. Pooled incidence of new-onset GERD symptoms was 20%, with a strong suggestion of heterogeneity. New-onset esophagitis ranged from 6.3% to 63.3%.


CONCLUSIONS
Because of high heterogeneity among available studies and paradoxical outcomes of objective esophageal function tests, the exact effect of laparoscopic SG on the prevalence of GERD remains unanswered. Surgeons should carefully evaluate preoperative GERD symptoms when choosing the proper bariatric technique.
Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, 3430 VB Nieuwegein, The Netherlands. Electronic address: j.oor@antoniusziekenhuis.nl.
Jelmer E
JE
Oor
Department of Surgery, Meander Medical Center, Maatweg 3, Amersfoort, The Netherlands.
David J
DJ
Roks
Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, 3430 VB Nieuwegein, The Netherlands.
Çagdas
Ç
Ünlü
Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, 3430 VB Nieuwegein, The Netherlands.
Eric J
EJ
Hazebroek
D005743:Gastrectomy / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D010535:Laparoscopy; D015233:Models, Statistical; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D015995:Prevalence; D016896:Treatment Outcome
Gastroesophageal reflux disease; Laparoscopic gastric sleeve; Sleeve gastrectomy