title: The effect of sleeve gastrectomy on extraesophageal reflux disease.
abstract: BACKGROUND
  Sleeve gastrectomy (SG) has been linked to increased rates of postoperative gastroesophageal reflux.
  
  
  OBJECTIVE
  The aim of this study was to evaluate whether SG is also linked to increased pulmonary extraesophageal reflux disease in a rodent model, based on histologic inflammatory distal airway changes.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Wistar rats (Charles River Institute, Wilmington, MA) were fed a high fat diet (HFD) for 4 months. They were divided into HFD only (n = 25) and SG+HFD (n = 19) groups and euthanized at 12 weeks, and the trachea and lungs were harvested en bloc then preserved for analysis by a blinded board-certified pathologist.
  
  
  RESULTS
  Rats who underwent SG were significantly less likely to show postmortem distal airway changes (4.0% versus 31.0%, P = .03), had a lower average chronic aspiration pneumonitis grade (.73 versus 1.57, P = .006), and had a lower total lung injury score (1.19 versus 2.28, P = .005). Alveolar hemorrhage was also less common in the SG+HFD group (37.5% versus 80.0%, P = .006).
  
  
  CONCLUSIONS
  SG is associated with increased incidence of normal lung histology on postmortem examination, less evidence of chronic aspiration pneumonitis and alveolar hemorrhage, and decreased total lung injury score in a rodent model. SG appears to have a protective effect on the pulmonary system. This suggests that SG does not exacerbate extraesophageal reflux effects on the pulmonary epithelium.
authors.affiliation: Division of Advanced Gastrointestinal, Foregut, Bariatric and General Surgery, Stony Brook University Medical Center, Stony Brook, New York.
authors.forename: Catherine
authors.initials: C
authors.lastname: Frenkel
authors.affiliation: Division of Advanced Gastrointestinal, Foregut, Bariatric and General Surgery, Stony Brook University Medical Center, Stony Brook, New York.
authors.forename: Dana A
authors.initials: DA
authors.lastname: Telem
authors.affiliation: Division of Advanced Gastrointestinal, Foregut, Bariatric and General Surgery, Stony Brook University Medical Center, Stony Brook, New York.
authors.forename: Aurora D
authors.initials: AD
authors.lastname: Pryor
authors.affiliation: Division of Advanced Gastrointestinal, Foregut, Bariatric and General Surgery, Stony Brook University Medical Center, Stony Brook, New York.
authors.forename: Maria S
authors.initials: MS
authors.lastname: Altieri
authors.affiliation: Department of Pathology, Stony Brook University Medical Center, Stony Brook, New York.
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Shroyer
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Stony Brook University Medical Center, Stony Brook, New York. Electronic address: Elliot.Regenbogen@stonybrookmedicine.edu.
authors.forename: Elliot
authors.initials: E
authors.lastname: Regenbogen
mesh_terms: D000818:Animals; D050110:Bariatric Surgery / Q000009:adverse effects*; D001835:Body Weight / Q000502:physiology; D059305:Diet, High-Fat; D004195:Disease Models, Animal; D005743:Gastrectomy / Q000009:adverse effects*; D005764:Gastroesophageal Reflux / Q000209:etiology*; D009767:Obesity, Morbid / Q000601:surgery; D011183:Postoperative Complications / Q000209:etiology; D011650:Pulmonary Alveoli / Q000473:pathology; D011658:Pulmonary Fibrosis / Q000209:etiology / Q000473:pathology; D017208:Rats, Wistar
keywords: Bariatric surgery; Extraesophageal reflux; Morbid obesity; Sleeve gastrectomy