• Emanuele Soricelli, Giovanni Casella, Giovanni Baglio, Roberta Maselli, Ilaria Ernesti, and Alfredo Genco.
• Department of Surgical Sciences, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy. Electronic address: emanuele.soricelli@gmail.com.
• Surg Obes Relat Dis. 2018 Jun 1; 14 (6): 751-756.

BackgroundThe postoperative development or worsening of gastroesophageal reflux disease (GERD) represents the major drawback of laparoscopic sleeve gastrectomy (SG). A GERD diagnosis is often based only on symptoms and proton pump inhibitors (PPI) intake, while objective tests like esophagogastroduodenoscopy and pH measurements are performed less frequently.ObjectivesTo evaluate the association between reflux symptoms and GERD-related esophageal lesions.SettingsUniversity hospital, Rome, Italy.MethodsA comprehensive clinical control entailing GERD symptoms, PPI intake, and esophagogastroduodenoscopy was proposed to all patients who underwent SG between June 2007 and February 2011, irrespective of the presence of GERD symptoms. One hundred forty-four of 219 patients agreed to take part in the study (follow-up rate: 65.8%).ResultsAfter a mean follow-up of 66 months, GERD symptoms and PPI intake were recorded in 70.2% and 63.9% of patients, respectively. Mean visual analogue scale score was 2.9 ± 3.3. The overall frequency of erosive esophagitis was 59.8%, while nondysplastic Barrett's esophagus was detected in 13.1%. The frequency of esophageal biliary reflux was 68%. GERD symptoms and visual analogue scale score were not significantly associated with the development of erosive esophagitis and Barrett's esophagus and the severity of the esophageal lesions. Moreover, the frequency of erosive esophagitis and Barrett's esophagus in patients consuming PPI were similar to that of patients without PPI.ConclusionSymptoms investigation alone is not a reliable tool to diagnose GERD after SG. The use of objective diagnostic tests, such as esophagogastroduodenoscopy, should be carefully considered in the postoperative follow-up schedule of SG patients.Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

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