The major complications were defined as intraluminal/intra-abdominal bleeding, staple line leak, sleeve stricture, along with other organ injury. conversion Mouse monoclonal to eNOS to gastric bypass or duodenal switch because of the severe reflux symptoms. At 18 months, the follow-up data were available in 60% of the total individuals. Summary: LSG results in resolution or improvement of the reflux symptoms in a large number of individuals. Proper individual selection, total preoperative evaluation to identify the presence of hiatal hernia, and good surgical techniques are the keys to accomplish optimal results. postoperative GERD, which is related to the gastric fundus removal, division of the gastroesophageal junction (GEJ) muscular materials, reduced antral pump action, significantly reduced gastric reservoir volume, and the presence of high pressure zone in the proximal gastric sleeve. Some experts even consider GERD to be a contraindication for sleeve gastrectomy. In the 2012 International Sleeve Gastrectomy Expert Panel Consensus Statement, 57% of the panelists agreed that GERD is definitely a relative contraindication for sleeve gastrectomy. The second International Sleeve Gastrectomy Summit found that 6.5% (range: 0-85%) of the individuals who have undergone sleeve gastrectomy experienced postoperative GERD. However, the presently available data on the effect of sleeve gastrectomy on postoperative GERD are Naphthoquine phosphate conflicting and difficult to interpret. The criteria used for the analysis of GERD are not usually obvious; routine use of preoperative endoscopy is definitely nonstandard; the lack of objective evidences of GERD during pH study and manometry in many studies, and lastly, the medical techniques used vary widely among the bariatric cosmetic surgeons. In morbidly obese patients, oftentimes RYGB is not feasible (in case of individuals with extremely high BMI or considerable intra-abdominal adhesions from earlier procedures) or not appropriate (Crohn’s disease, pernicious anemia, etc.). These contraindications leave sleeve gastrectomy as the only viable surgical option, despite known issues and debates of the possible GERD symptoms after operation. Therefore, in this study, we investigated the status of the reflux symptoms after laparoscopic sleeve gastrectomy (LSG) for the treatment of morbid obesity. Materials and Methods A prospectively managed database of all the consecutive individuals who underwent LSG from February 2008 to May 2011 was retrospectively examined. Prior to starting the study, approval from your institutional review table was Naphthoquine phosphate obtained. Patient demographic data include age, sex, gender, BMI, preoperative extra body weight, and the number of obesity-related comorbidities (e.g., diabetes mellitus, hypertension, hyperlipidemia, obstructive sleep apnea, pulmonary hypertension, osteoarthritis, pseudotumor cerebri, GERD, polycystic ovarian syndrome, nonalcoholic steatohepatitis, major depression, and stress urinary incontinence). The pre- and postoperative symptoms of heartburn, reflux, or GERD were determined by the patient’s subjective descriptions. The individuals with severe reflux symptoms or known large hiatal hernias were offered to pursue RYGB. In addition to standard nutritional and psychiatric evaluations, we also performed routine preoperative esophagogastroduodenoscopy (EGD) in all the individuals to rule out the presence of any subclinical esophageal and gastric disorders. Careful attention was paid to identify the presence of hiatal hernia during endoscopic retroflexion, which Naphthoquine phosphate is uniformly repaired during the operation. In most of the instances, hiatal hernia restoration was accomplished by the placement of several posterior interrupted nonabsorbable sutures. Program mesh reinforcement was not part of the hiatal hernia restoration. Loose sleeve gastrectomy was performed using a 36-Fr bougie (ConMed Endosurgery, Utica, New York, USA), starting approximately 4-6 cm from your pylorus. The staple collection was either reinforced using Seamguard? (Gore, Flagstaff, AZ, US) or suture imbricated using Endo Stitch? (Covidien, Norwalk, CT, US) based on the surgeon’s preference. The major complications were defined as intraluminal/intra-abdominal bleeding, staple collection leak, sleeve stricture, along with other organ injury. All the individuals were pre- and postoperatively interviewed to evaluate their reflux symptoms. Results A total of 131 individuals, 98.