Outcomes of Concomitant Laparoscopic Crural Repair of Hiatal Hernia with Sleeve Gastrectomy: Systematic Review and Meta-Analysis
Notice bibliographique
Résumé
Abstract Background Hiatus hernia (HH) is prevalent among patients with obesity. Concurrent repair is often performed during bariatric surgeries, but a consensus on the safety and effectiveness of concurrent HH repair (HHR) and bariatric surgeries remains unclear. This systematic review was conducted to investigate the effectiveness and clinical outcomes of laparoscopic sleeve gastrectomy (LSG) when performed concurrently with crural repair of hiatal hernia in patients with obesity. Methods A systematic search of PubMed, Cochrane, and Embase was performed to find all the relevant articles. The methodological quality of the included studies was evaluated using the Newcastle-Ottawa scale. The primary outcomes were postoperative GERD rate, esophagitis, and weight loss. Secondary outcomes included effect on comorbidity prevalence, postoperative complications, and mortality. The PRISMA guidelines were used to carry out the present systematic review. Meta-analyses were performed using the Review Manager software. Results Twenty-five articles with a total of 163,766 patients; 72,287 in the LSG with HHR (group-1) and 91,479 in the LSG without HHR (group-2), met the inclusion criteria and included in the meta-analyses. In group-1, 59.4 % of subjects presented with clinical GERD symptoms preoperatively compared to only 35.6 % postoperative (p < 0.001). The study reported also a significant reduction in the risk of esophagitis by 73% after the operation. The post operative GERD in group-1 (21.3%) was insignificantly lower than that of the group-2 (23.5%) since p = 0.34, while the de novo GERD in group-1 (13%) was significantly lower than that in group-2 (25.5%) since p = 0.0001. However, the post-operatively proton pump inhibitors use was significantly higher in group-1 (13.7%) compared to (10.5%) among the group-2. The mean %EWL, and mean %TWL were similar between the two operations (p = 0.81 and 0.49 respectively). The rate of bleeding was 0.64% and 0.71% in group-1 and group-2, respectively (p = 0.42). Post operative interventions were similar between the 2 operations (p = 0.85). Conclusions This study revealed that both LSG with concomitant HHR and without are effective in terms of reflux resolution and weight outcomes, with superiority of LSG + HHR in terms of GERD control. Both strategies can therefore be suggested in subjects with obesity and concomitant hiatal hernia and/or GERD.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,004 | 0,001 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».