Gastroesophageal reflux disease after laparoscopic sleeve gastrectomy
Bibliographic record
Abstract
Cite in Vancouver style as: Kurmanskyi AO, Kebkalo AB. Gastroesophageal reflux disease after laparoscopic sleeve gastrectomy. Inter Collegas. 2024;11(2):4-12. https://doi.org/10.35339/ic.11.2.kuk Archived: https://doi.org/10.5281/zenodo.15738035 Abstract Background. GastroEsophageal Reflux Disease (GERD) is a common problem among obese and overweight people, including as a complication of bariatric surgery, Laparoscopic Sleeve Gastrectomy (LSG). Aim. To conduct a retrospective analysis of the frequency of GERD in patients with morbid obesity after laparoscopic sleeve gastrectomy. Materials and Methods. In this retrospective study, data from 152 patients who underwent LSG were analyzed. All patients were diagnosed with morbid obesity and were deemed suitable for surgery. The minimum follow-up period was twelve months. All patients were assessed preoperatively for the severity of GERD using 24-hour pH monitoring, and upper gastrointestinal tract examination via FibroGastroDuodenoScopy (FGDS) to identify signs of reflux disease, esophagitis and Barrett's esophagus and GERD-HRQL (Health-Related Quality of Life) questionnaire. Results. During the study, out of 152 patients without GERD (DeMeester Index (DMI) was 6.87±3.38), 23 (15.1%) of them within 12 months after LSG developed de novo GERD (DMI 9.12±8.87, p=0.04). In four patients with de novo GERD, esophagitis grade A was detected. The pathomechanism of GERD following LSG was multifactorial, caused by a combination of anatomical, physiological, and physical factors. Contributing factors included the shape of the sleeve, damage to the lower esophageal sphincter, and esophageal motility disorders. Conclusions. LSG is effective in promoting weight loss, but poses a significant risk of developing GERD. Our study found a 15.1% incidence of GERD after LRH, which is lower than other studies, probably due to the routine use of 24-hour pH monitoring to identify patients with asymptomatic GERD. Anatomical changes due to LSG, in particular resection of the gastric fundus and dissection in the area of the angle of His, increase the temporary relaxation of the lower esophageal sphincter, contributing to the development of GERD. Keywords: bariatric surgery, morbid obesity, GERD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".