Do Abdominoplasties in Patients with Prior Sleeve Gastrectomy Impact De Novo Gastroesophageal Reflux Disorder and the Need for Conversion to Roux-en-Y Gastric Bypass?

Oct 30, 2024Journal of laparoendoscopic & advanced surgical techniques. Part A

Does Tummy Tuck Surgery After Sleeve Gastrectomy Increase New Acid Reflux and Need for Further Weight Loss Surgery?

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Abstract

A total of 630 patients underwent conversion from sleeve gastrectomy to Roux-en-Y gastric bypass.

Patients who had abdominoplasties prior to conversion for gastroesophageal reflux disorder (GERD) numbered 29 (8.6%), compared to 12 (4.1%) in the inadequate weight loss group.
Hiatal hernias were more prevalent in patients converted for GERD (98 patients, 28.9%) than in those converted for inadequate weight loss (46 patients, 15.8%).
The presence of hiatal hernias during surgery was identified as a significant predictor of GERD, with an odds ratio of 2.7.
Abdominoplasty does not appear to directly influence the development of GERD in patients who have previously undergone sleeve gastrectomy.

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The sleeve gastrectomy (SG) often requires conversion to Roux-en-Y gastric bypass (RYGB) due to gastroesophageal reflux disorder (GERD). Many postbariatric patients seek body-contouring surgery such as abdominoplasty to remove unwanted skin and fat. Although the number of abdominoplasties performed in postbariatric patients is increasing each year, the number of conversion surgeries is increasing in accordance. This study evaluates the impact of abdominoplasties in patients with prior SG on the development of GERD and the need for conversion to RYGB.A retrospective study was conducted with 630 patients who underwent conversions from SG to RYGB at our institution between January 2014 and December 2023. Outcomes were stratified for comparison between patients with GERD as an indication for conversion and patients with inadequate weight loss as an indication for conversion. Between the two groups we compared the number of patients with post-SG abdominoplasty and the number of hiatal hernias (HH) seen during conversion surgery. A logistic regression analysis was performed to identify factors independently associated with GERD.There was a statistically significant higher number of abdominoplasties in patients who underwent conversion to RYGB for GERD (29 patients, 8.6%) compared to inadequate weight loss (12 patients, 4.1%),value .034. However, these patients also had statistically significantly more HH (98 patients, 28.9%) compared to patients with inadequate weight loss as an indication for conversion (46 patients, 15.8%),value <.001. In the logistic regression comparing these two variables, only the presence of HH seen during surgery was found to be a significant predictor of GERD (odds ratio 2.7, confidence interval 1.7-4.1,< .001).Our data shows that abdominoplasty surgery does not directly influence the development of GERD in post-SG patients. However, the presence of HH in this population significantly impacts the development of GERD, often necessitating conversion to RYGB. Introduction: Methods: Results: Conclusion: P P P

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Do Abdominoplasties in Patients with Prior Sleeve Gastrectomy Impact De Novo Gastroesophageal Reflux Disorder and the Need for Conversion to Roux-en-Y Gastric Bypass?

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