LAPAROSCOPIC SLEEVE GASTRECTOMY AND HIATAL HERNIA REPAIR IN OBESE PATIENTS: THE POSSIBLE EFFECT ON GASTROESOPHAGEAL REFLUX DISEASE

P1341 LAPAROSCOPIC SLEEVE GASTRECTOMY AND HIATAL HERNIA REPAIR IN OBESE PATIENTS: THE POSSIBLE EFFECT ON GASTROESOPHAGEAL REFLUX DISEASE A. Santonicola1, L. Angrisani2, S. Gallotta3, L. Pellegrini3, C. Caputo3, C. Ciacci3, P. Iovino3. 1Clinical and Experimental Medicine, Federico II University of Naples, 2General and Endoscopic Surgery Unit, S.Giovanni Bosco Hospital, Naples, 3Medicine and Surgery, University of Salerno, Salerno, Italy E-mail Address: antonellasantonicola83@gmail.com INTRODUCTION: Obesity is an independent risk factor for Gastro-esophageal reflux disease (GERD), that is often associated to the presence of a hiatal hernia(HH). Laparoscopic sleeve gastrectomy (LSG) is gaining increasing popularity in the surgical treatment of obese patients, but current data of its effect on GERD are controversial. AIMS & METHODS: Aim: to evaluate the effect of LSG with or without the concomitant HH repair (HHR) on GERD symptoms in obese patients. 78 consecutive patients in which HH was diagnosed underwent LSG with concomitant HHR (LSG+HHR group); 102 patients, matched for age and gender, in which no HH was disclosed were submitted to the only LSG (LSG-group). All patients underwent a multidisciplinary assessment before and after at least six months from surgical procedure, including a double-contrast barium swallow, an upper-gastrointestinal and a standardized questionnaire for the assessment of typical GERD symptoms (heartburn and regurgitation). Table 1. Frequency-intensity scores of typical GERD symptoms in LSG+HHR group and LSG Regurgitation 1.32 }1.82 1.07 }1.68 1.26 }1.99 0.60 }1.47 RESULTS: Before the surgery, the prevalence of typical GERD symptoms did not differ between LSG+HHR(38.5%) and LSG patients(39.2%) (c2,p = 0.92). Heartburn and regurgitation frequency-intensity scores were similar between LSG+HHR and LSG group(Mann-Whitney, p = 0.54 and p = 0.47, respectively)(Table 1). At follow-up, the prevalence of GERD symptoms was not significantly different between LSG+HHR and LSG group (c2,p = 0.08) but LSG+HHR patients showed a significantly higher heartburn frequency-intensity score compared to LSG patients(M-W, p = 0.009). The comparison within LSG-group before and after the surgery showed that there was a significant improvement of typical GERD symptoms prevalence after the surgery (McNemar test, p = 0.003), but there was no difference in heartburn and regurgitation frequency-intensity scores (Wilcoxon, p = 0.5 and p = 0.6, respectively). No significant differences were found comparing the prevalence and the heartburn and regurgitation frequency-intensity scores before and after the surgery in LSG+HHR group. CONCLUSION: At follow-up, in patients submitted to LSG the prevalence of typical GERD symptoms significantly decreased; moreover, in patients who underwent LSG with concomitant HHR the heartburn intensity-frequency score was higher compared to patients who received only LSG. Disclosure of Interest: None Declared Gut 2012; 61 (Suppl 3) A383