Daniel Moon, MD, Ahmad Bashir, MD, Jennifer Higa, BS MPH, Saber Ghiassi, MD MPH, Tienchin Ho, MD FACS, Keith Boone, MD FACS, Kelvin Higa, MD FACS. Department of Surgery, UCSF- Fresno Medical Education Program
Introduction: Hiatal hernia repair during laparoscopic adjustable gastric banding has been shown to improve outcomes and surgical reoperations. We questioned if hiatal hernia repair during laparoscopic Roux-en-Y gastric bypass (LRYGB) had the same effect.
Methods: We compared a 2006 cohort without routine hiatus dissection (Group 1) to a 2008 cohort with routine dissection (Group 2) for weight loss and reflux symptoms. All procedures were performed by a single surgeon. Hiatal dissections were complete and hiatal hernias, when present, were repaired by posterior crural approximation. Weight loss data was obtained from measurements at post-op office visits and analyzed using Student’s t-test. Reflux data was obtained from a mailed survey and analyzed using Chi-squared test.
Results: There were a total of 385 patients from Group 1 and 369 patients from Group 2 available for study. Weight loss data was available on 136 patients at two years and 92 patients at three years post-op for Group 1, and for 105 patients at two years and 20 patients at three years post-op for Group 2. Percent excess weight loss did not differ between groups (Table 1). Return percentage for GERD Survey was 26% from Group 1, and 33% from Group 2. Reflux was reported in more Group 1 patients than Group 2 patients, though daily reflux medication use was similar (Table 2).
Conclusions: Excess weight loss at 2 and 3 years is unchanged by the addition of routine hiatus dissection to LRYGB, however, GERD symptoms were improved by addition of this practice.
| Year 2||69.2% (n=120)||68.0% (n=105)||p = 0.61|
|Year 3||64.4% (n=92)||58.1% (n=20)||p = 0.24|
|Group 1 (n=100)||Group 2 (n=120)|
|Reported Reflux||31%||18%||p = <0.05|
|Medication Use||18%||16%||p = 0.67|
Session Number: Poster – Poster Presentations
Program Number: P499