الفهرس 
Anatomy of esophagusOnly 14 pages are availabe for public view
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Abstract
Obesity is an important risk factor in the development of GERD and its associated complications. Weight loss following lifestyle modification has been shown to significantly alleviate GERD symptoms. With regards to bariatric surgery and its effect on GERD, studies have shown inconsistencies with different types of bariatric surgery.
LSG is a safe bariatric procedure for weight loss with acceptable postoperative morbidity and mortality rates and reduce the risk for postoperative comorbidities.
Although GERD is a common disease in morbidly obese patients, there is lack of common policy concerning the required investigations for precise diagnosis and accurate assessment of 4 Furthermore, since preoperative diagnosis of HH is often missing, the need for meticulous intra-operative evaluation of the hiatus is indispensable. Sleeve gastrectomy may improve or aggravate existing GERD or may lead to de novo reflux. There is no consensus among investigators on the effects of SG in LES function and on the mechanisms responsible for the outcome of existing GERD and the development of de novo GERD.
Although LSG appears to be an appealing alternative in terms of weight loss, The results showed that this operation is associated with postoperative GERD. When indicating LSG, the surgeon should be clear enough in warning patients that they might need PPI’s after the operation, and that symptoms are not reliable for the diagnosis of GERD. Surgeons should probably increase their threshold for indicating RYGB in patients with known preoperative GERD.
Currently, the effect of SG on GERD remains controversial. In addition there remains marked heterogeneity among the studies assessing GERD following SG. Assessment using a common objective standard for the evaluation of GERD, such as 24-hour pH monitoring, is lacking. Differences in surgical technique among studies may also contribute to difficulty comparing GERD following SG . Randomized controlled trials are needed with both objective and subjective measures of GERD to clarify this controversy in the future.