PMID- 33877508 OWN - NLM STAT- MEDLINE DCOM- 20210720 LR - 20211222 IS - 1708-0428 (Electronic) IS - 0960-8923 (Linking) VI - 31 IP - 8 DP - 2021 Aug TI - Do Preoperative Esophageal pH Monitoring and High-Resolution Manometry Predict Symptoms of GERD After Sleeve Gastrectomy? PG - 3490-3497 LID - 10.1007/s11695-021-05427-5 [doi] AB - BACKGROUND: Predictive factors of evolution or appearance of gastroesophageal reflux disease (GERD) after sleeve gastrectomy (SG) have not been identified to date. We aimed to assess the evolution of GERD symptoms 1 year after SG and to determine preoperative predictive factors using high-resolution manometry (HRM) and ambulatory 24-h esophageal pH monitoring (APM). METHODS: We included 160 patients who underwent SG between 2013 and 2017 and performed preoperative APM and HRM. Positive APM was defined according to the Lyon consensus. Symptoms of GERD, proton pump inhibitors (PPI) use, weight loss (WL), and diet were recorded in all patients before and 1 year after surgery. RESULTS: One year after surgery, 58 patients (36.3%) complained of GERD symptoms compared to 52 patients (32.5%) preoperatively (p=0.48). Among patients with preoperative GERD symptoms, only 26/52 patients (50%) still had symptoms, whereas 32/108 (29.6%) asymptomatic patients developed de novo GERD symptoms after surgery. PPI use increased after surgery reaching 36.9% of patients against 15.0% before (p<0.0001). Only preoperative symptoms of GERD were predictive of postoperative symptoms (OR= 2.47 [1.14-5.45]; p=0.023) in multivariate analysis. Preoperative manometric parameters, postoperative diet, and WL were not related to postoperative symptoms. In asymptomatic patients before surgery, silent GERD (positive APM without symptom) was predictive of postoperative GERD symptoms (OR=2.69 [1.00-7.25]; p=0.049). CONCLUSION: Evolution of GERD symptoms after SG reveals improvement for half of the patients and de novo GERD symptoms in one-third of patients. Predictive factors of postoperative symptoms are preoperative symptoms and positive preoperative APM in asymptomatic patients. CI - (c) 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. FAU - Soliman, Heithem AU - Soliman H AUID- ORCID: 0000-0003-1644-7272 AD - Centre de Recherche sur l'Inflammation, Inserm UMRS 1149, Universite de Paris, 75018, Paris, France. heithemsoliman90@hotmail.com. AD - Departement d'Hepato Gastro Enterologie, Hopital Louis Mourier, DMU ESPRIT - GHU (AP-HP), 178 rue des Renouillers, 92700, Colombes, France. heithemsoliman90@hotmail.com. FAU - Coupaye, Muriel AU - Coupaye M AD - Centre de Recherche sur l'Inflammation, Inserm UMRS 1149, Universite de Paris, 75018, Paris, France. AD - Service des Explorations Fonctionnelles, Centre Integre Nord Francilien de prise en charge de l'Obesite (CINFO), Hopital Louis Mourier (AP-HP), 92700, Colombes, France. FAU - Cohen-Sors, Boris AU - Cohen-Sors B AD - Centre de Recherche sur l'Inflammation, Inserm UMRS 1149, Universite de Paris, 75018, Paris, France. AD - Departement d'Hepato Gastro Enterologie, Hopital Louis Mourier, DMU ESPRIT - GHU (AP-HP), 178 rue des Renouillers, 92700, Colombes, France. FAU - Gorbatchef, Caroline AU - Gorbatchef C AD - Departement d'Hepato Gastro Enterologie, Hopital Louis Mourier, DMU ESPRIT - GHU (AP-HP), 178 rue des Renouillers, 92700, Colombes, France. FAU - Dior, Marie AU - Dior M AD - Departement d'Hepato Gastro Enterologie, Hopital Louis Mourier, DMU ESPRIT - GHU (AP-HP), 178 rue des Renouillers, 92700, Colombes, France. FAU - Nebunu, Nicoleta AU - Nebunu N AD - Departement d'Hepato Gastro Enterologie, Hopital Louis Mourier, DMU ESPRIT - GHU (AP-HP), 178 rue des Renouillers, 92700, Colombes, France. FAU - Latrache, Sofya AU - Latrache S AD - Departement d'Hepato Gastro Enterologie, Hopital Louis Mourier, DMU ESPRIT - GHU (AP-HP), 178 rue des Renouillers, 92700, Colombes, France. FAU - Le Gall, Maude AU - Le Gall M AD - Centre de Recherche sur l'Inflammation, Inserm UMRS 1149, Universite de Paris, 75018, Paris, France. FAU - Bado, Andre AU - Bado A AD - Centre de Recherche sur l'Inflammation, Inserm UMRS 1149, Universite de Paris, 75018, Paris, France. FAU - Ledoux, Severine AU - Ledoux S AD - Centre de Recherche sur l'Inflammation, Inserm UMRS 1149, Universite de Paris, 75018, Paris, France. AD - Service des Explorations Fonctionnelles, Centre Integre Nord Francilien de prise en charge de l'Obesite (CINFO), Hopital Louis Mourier (AP-HP), 92700, Colombes, France. FAU - Coffin, Benoit AU - Coffin B AD - Centre de Recherche sur l'Inflammation, Inserm UMRS 1149, Universite de Paris, 75018, Paris, France. AD - Departement d'Hepato Gastro Enterologie, Hopital Louis Mourier, DMU ESPRIT - GHU (AP-HP), 178 rue des Renouillers, 92700, Colombes, France. FAU - Duboc, Henri AU - Duboc H AD - Centre de Recherche sur l'Inflammation, Inserm UMRS 1149, Universite de Paris, 75018, Paris, France. AD - Departement d'Hepato Gastro Enterologie, Hopital Louis Mourier, DMU ESPRIT - GHU (AP-HP), 178 rue des Renouillers, 92700, Colombes, France. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210420 PL - United States TA - Obes Surg JT - Obesity surgery JID - 9106714 SB - IM MH - Esophageal pH Monitoring MH - Gastrectomy MH - *Gastroesophageal Reflux/diagnosis/etiology MH - Humans MH - *Laparoscopy MH - Manometry MH - *Obesity, Morbid/surgery OTO - NOTNLM OT - 24-h pH monitoring OT - Dietary habits OT - Gastroesophageal reflux disease OT - High-resolution esophageal manometry OT - Sleeve gastrectomy EDAT- 2021/04/21 06:00 MHDA- 2021/07/21 06:00 CRDT- 2021/04/20 12:25 PHST- 2020/12/07 00:00 [received] PHST- 2021/04/13 00:00 [accepted] PHST- 2021/04/08 00:00 [revised] PHST- 2021/04/21 06:00 [pubmed] PHST- 2021/07/21 06:00 [medline] PHST- 2021/04/20 12:25 [entrez] AID - 10.1007/s11695-021-05427-5 [pii] AID - 10.1007/s11695-021-05427-5 [doi] PST - ppublish SO - Obes Surg. 2021 Aug;31(8):3490-3497. doi: 10.1007/s11695-021-05427-5. Epub 2021 Apr 20.