Intrathoracic Sleeve Migration Following Sleeve Gastrectomy: Incidence and Outcomes.

Obes Surg

Bariatric & Metabolic Surgery Center, H Plus Yangji Hospital, 1636, Nambusunhwan-Ro, Gwanakgu, Seoul, 08779, Korea.

Published: October 2024

AI Article Synopsis

  • * A review of 206 patient charts revealed that 14% experienced ITM, which was associated with more severe postoperative reflux symptoms and a longer use of anti-reflux medication.
  • * Patients with ITM also had a higher incidence of esophagitis confirmed through examinations, establishing a significant link between ITM and adverse clinical outcomes.

Article Abstract

Purpose: With laparoscopic sleeve gastrectomy (LSG) taking its place as the primary metabolic bariatric procedure in the past decade, de novo or persistent gastroesophageal reflux disease (GERD) has come into the spotlight as one of the most debilitating postoperative complications. Among the causes of GERD, intrathoracic migration (ITM) of the sleeve has become an understated yet significant phenomenon. This study aims to analyze the actual incidence of spontaneous ITM at our center, as well as its relationship to the baseline characteristics of patients and perioperative outcomes.

Materials And Methods: A retrospective chart review of 206 patients who had undergone LSG at our center from July 2019 to December 2022 was done. At 1-year follow-up, a non-enhanced abdominopelvic computed tomography (CT) scan and esophagogastroduodenoscopy (EGD) were performed, and these exams were repeated annually. Baseline characteristics and perioperative outcomes including the clinical disease course of GERD were compared.

Results: The incidence of ITM was 14% (n = 29). There was a significant correlation between ITM and postoperative reflux symptoms (p = 0.001). The mean duration of anti-reflux medication use was also significantly longer in the ITM group than in the no ITM group at 17 and 11 months, respectively (p = 0.004). A significantly higher number of patients in the ITM group were diagnosed with esophagitis on postoperative EGD than in the no ITM group (p = 0.002).

Conclusion: The incidence of ITM using non-enhanced CT was 14%. ITM was significantly correlated to clinical reflux and EGD-confirmed esophagitis.

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Source
http://dx.doi.org/10.1007/s11695-024-07525-6DOI Listing

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