Sleeve Gastrectomy with Crural Repair in Obese Patients with Gastroesophageal Reflux Disease and Hiatus Hernia; a Cohort Study

Introduction: Hiatal hernia (HH) or gastroesophageal reflux disease (GERD) is increasingly acknowledged as a co-morbidity associated with obesity. The most successful bariatric treatment for treating morbidly obese individuals with GERD and/or HH is still the Roux-en-Y gastric bypass. On the other hand, there is ongoing discussion on the appropriateness of laparoscopic sleeve gastrectomy (SG) for these individuals. Reporting our experience with 40 patients who had SG and HH repair (HHR) was our goal.Patients and methods: The results of patients who had SG with crural repair to treat GERD symptoms or HH were analyzed across many centers. The Reflux index questionnaire (RSI), stopping antireflux medication, and radiographic or endoscopic signs of HH recurrence were all taken into consideration while evaluating the clinical result.Results: RSI scores were significantly reduced postoperatively. There was significant resolution of GERD symptoms postoperatively (p=0.001). There were no postoperative complications. Two of our patients required conversion to roux en y gastric bypass (RNYGB) to control persistent postoperative GERD.Conclusion: LSG with cruroplasty is an effective and safe method for weight reduction and treatment of GERD caused by HH in morbid obese patients.