The role of cardioesophageal lipoma in the formation of hiatal hernia in patients after bariatric surgery
https://doi.org/10.52581/1814-1471/83/09
Abstract
The purpose of this study was to determine the role of cardioesophageal lipoma in the development of hiatal hernia in patients after bariatric surgery.
Material and methods. The research involved three groups of patients: patients with obesity without a hiatal hernia, who subsequently underwent a sleeve gastrectomy (1st group, 54 people); patients with normal body mass index (BMI) and diagnosed hiatal hernia (2nd group, 56 people); patients with normal BMI without hiatal hernia (3nd group, 60 people). The assessment of the area of visceral fat and cardioesophageal lipoma was determined according to the MSCT data of the abdomen. Patients completed a questionnaire using the GERD-HRQL, patients of 1st group (after bariatric surgery) completed a questionnaire using the BAROS.
Results and discussion. We noted a higher incidence of cardioesophageal lipoma in obese patients (70.4%). In obese patients after a bariatric procedure, along with a decrease in BMI, not only the area of internal visceral fat, but also the area of cardioesophageal lipoma significantly decreases, which led to the formation of hiatal hernia in 68.75% of patients.
Conclusion. The data obtained indicate a high incidence of cardioesophageal lipoma in obese patients. Cardioesophageal lipoma is an important pathogenetic link in the development of hiatal hernia, and, as a result of gastroesophageal reflux, in bariatric patients in the late postoperative period.
About the Authors
D. A. Kim
Novosibirsk State Medical University; Medical Center Avicenna
Russian Federation
Russian Federation
Denis A. Kim – Cand. Med. sci., Assistant, the Department of Postgraduate of Surgeons, Novosibirsk SMU; surgeon of the 1st Surgical Department, MC «Avicenna».
52, Krasny Ave., 630091, Novosibirsk; 17/1, Kommunisticheskaya st., 630099, Novosibirsk
V. V. Anischenko
Novosibirsk State Medical University; Medical Center Avicenna
Russian Federation
Russian Federation
Vladimir V. Anisсhenko – Dr. Med. sci., Professor, head of the Department of Postgraduate of Surgeons, Novosibirsk SMU; Scientific Consultant in Surgery MC «Avicenna».
52, Krasny Ave., 630091, Novosibirsk; 17/1, Kommunisticheskaya st., 630099, Novosibirsk
V. G. Kulikov
Institute for Chemical Biology and Fundamental Medicine, the Siberian Branch of the Russian Academy of Sciences
Russian Federation
Russian Federation
Vitaliy G. Kulikov – Cand. Med. sci., head of the Department of Radiation Diagnostics.
8, Academic Lavrentiev Ave., Novosibirsk, 630090
P. A. Patrushev
Novosibirsk State Medical University; Medical Center Avicenna
Russian Federation
Russian Federation
Petr A. Patrushev – postgraduate student, the Department of Postgraduate of Surgeons, Novosibirsk SMU; surgeon of the 1st Surgical Department, MC «Avicenna».
52, Krasny Ave., 630091, Novosibirsk; 17/1, Kommunisticheskaya st., 630099, Novosibirsk
References
1. Hutopila I., Copaescu C. Hiatal Hernia is More Frequent than Expected in Bariatric Patients. Intraoperative Findings during Laparoscopic Sleeve Gastrectomy. Chirurgia. 2019;114(6):779-789. https://doi:10.21614/chirurgia.114.6.779
2. Fass O.Z., Mashimo H. The Effect of Bariatric Surgery and Endoscopic Procedures on Gastroesophageal Reflux Disease. J Neurogastroenterol Motil. 2021;27(1):35-45. https://doi:10.5056/jnm20169
3. Corley D.A., Kubo A., Levin T.R., et al. Abdominal obesity and body mass index as risk factors for Barrett's esophagus. Gastroenterology. 2007;133:34-41. quiz 311. doi.org/10.1053/j.gastro.2007.04.046
4. Edelstein Z.R., Farrow D.C., Bronner M.P., Rosen S.N., Vaughan T.L. Central adiposity and risk of Barrett's esophagus. Gastroenterology. 2007;133:403-411. doi.org/10.1053/j.gastro.2007.05.026
5. Pandolfino J.E., El-Serag H.B., Zhang Q., et al. Obesity: a challenge to esophagogastric junction integrity. Gastroenterology. 2006;130:639-649. doi.org/10.1053/j.gastro.2005.12.016
6. El-Serag H.B., Ergun G.A., Pandolfino J., et al. Obesity increases oesophageal acid exposure. Gut. 2006;56(6):749-755. doi.org/10.1136/gut.2006.100263
7. Kardasheva S.S. Rol' faktora izbytochnogo vesa v razvitii simptomov, oslozhneniya i lecheniya GERB [The role of the overweight factor in the development of symptoms, complications and treatment of GERD]. Rossijskiy zhurnal gastrojenterologii, gepatologii, koloproktologii. 2016;20(5):10-11 (in Russ.).
8. Raj P.P., Bhattacharya S., Misra S., et al. Gastroesophageal reflux-related physiologic changes after sleeve gastrectomy and Roux-en-Y gastric bypass: a prospective comparative study. Surg Obes Relat Dis. 2019;15:1261-1269. doi: 10.1016/j.soard.2019.05.017
9. Pilone V., Tramontano S., Renzulli M., Zulli C., Schiavo L. Gastroesophageal reflux after sleeve gastrectomy: new onset and effect on symptoms on a prospective evaluation. Obes Surg. 2019;29:3638–3645. doi: 10.1007/s11695-019-04046-5
10. Viscido G., Gorodner V., Signorini F., et al. Laparoscopic sleeve gastrectomy: endoscopic findings and gastroesophageal reflux symptoms at 18-month follow-up. J Laparoendosc Adv Surg Tech A. 2018;28:71-77. doi: 10.1089/lap.2017.0398
11. Borbély Y., Schaffner E., Zimmermann L. De novo gastroesophageal reflux disease after sleeve gastrectomy: role of preoperative silent reflux. Surg Endosc. 2019;33:789-793. doi: 10.1007/s00464-018-6344-4
Review
For citations:
Kim D.A., Anischenko V.V., Kulikov V.G., Patrushev P.A. The role of cardioesophageal lipoma in the formation of hiatal hernia in patients after bariatric surgery. Issues of Reconstructive and Plastic Surgery. 2022;25(4):85-91. (In Russ.) https://doi.org/10.52581/1814-1471/83/09
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