A randomized trial comparing reflux symptoms in sleeve gastrectomy patients with or without hiatal hernia repair

Abstract Background The effect of the laparoscopic sleeve gastrectomy (SG) on reflux symptoms is unclear. Many surgeons only offer SG to patients with minor or no reflux symptoms, fearing that patients with severe reflux symptoms will having worsening of their condition after SG. Many will also advocate the need for crural repair at the time of SG to prevent de novo or worsening reflux symptoms. All the while, this is done without suitable data to make such conclusions. Objective To determine the impact of SG with or without hiatal hernia repair (HHR) on reflux symptoms. Setting University of Texas Health Sciences Center in Houston Methods The Gastrointestinal Symptom Rating Scale (GSRS) was determined in 100 consecutive, pre-operative SG who were then randomized into a crural repair group or non-repair group in a parallel design. They were subsequently followed up every three months for one year. We compared their demographics, body mass index (BMI), weight loss, presence and size of hiatal hernia, and GSRS for 12 months, comparing the groups’ reflux symptoms. Results We had 78% follow-up at a year and showed that there was a significant decrease in the GSRS within both groups (P