Asaad Salama1, Tamer Saafan2, Walid El Ansari3, Mohsen Karam4, Moataz Bashah4. 1. Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. asaadfayrouz@live.com. 2. Department of General Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. 3. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar. 4. Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Abstract
BACKGROUND: Controversy exists as to whether routine preoperative esophagogastroduodenoscopy (p-OGD) in bariatric surgery should be routinely undertaken or undertaken selectively based on patients' symptoms. As very few studies have focused on the role of p-OGD prior to the increasingly common laparoscopic sleeve gastrectomy (LSG), we assessed the role/impact of p-OGD in LSG patients. METHODS: Retrospective review of records of all LSG patients operated upon at Hamad General Hospital, Qatar (2011-2014, n = 1555). All patients were screened by p-OGD. Patient characteristics were analyzed, and p-OGD findings were categorized into four groups employing Sharaf et al.'s classification (Obes Surg 14:1367-1372, 23). We assessed the impact of p-OGD findings on any change in surgical management or lack thereof. RESULTS: p-OGD findings indicated that 89.5% of our patients had normal or mild findings and were asymptomatic (groups 0 and 1, not necessitating any change in surgical management), and no patients had gastric cancer or varices (group 3). A total of 10.5% of our sample were categorized as group 2 patients who, according to Sharaf et al. (Obes Surg 14:1367-1372, 23), might have their surgical approach changed. All patients diagnosed preoperatively with hiatal hernia (HH) had LSG with crural repair and their symptoms resolved postoperatively. CONCLUSION: Due to effectiveness and best utilization of resources, routine p-OGD screening in patients scheduled for LSG may require further justification for asymptomatic patients especially in regions with low upper GI cancers. p-OGD findings had low impact on the management of asymptomatic patients. Crural repair plus LSG was effective for hiatal hernia.
BACKGROUND: Controversy exists as to whether routine preoperative esophagogastroduodenoscopy (p-OGD) in bariatric surgery should be routinely undertaken or undertaken selectively based on patients' symptoms. As very few studies have focused on the role of p-OGD prior to the increasingly common laparoscopic sleeve gastrectomy (LSG), we assessed the role/impact of p-OGD in LSG patients. METHODS: Retrospective review of records of all LSG patients operated upon at Hamad General Hospital, Qatar (2011-2014, n = 1555). All patients were screened by p-OGD. Patient characteristics were analyzed, and p-OGD findings were categorized into four groups employing Sharaf et al.'s classification (Obes Surg 14:1367-1372, 23). We assessed the impact of p-OGD findings on any change in surgical management or lack thereof. RESULTS: p-OGD findings indicated that 89.5% of our patients had normal or mild findings and were asymptomatic (groups 0 and 1, not necessitating any change in surgical management), and no patients had gastric cancer or varices (group 3). A total of 10.5% of our sample were categorized as group 2 patients who, according to Sharaf et al. (Obes Surg 14:1367-1372, 23), might have their surgical approach changed. All patients diagnosed preoperatively with hiatal hernia (HH) had LSG with crural repair and their symptoms resolved postoperatively. CONCLUSION: Due to effectiveness and best utilization of resources, routine p-OGD screening in patients scheduled for LSG may require further justification for asymptomatic patients especially in regions with low upper GI cancers. p-OGD findings had low impact on the management of asymptomatic patients. Crural repair plus LSG was effective for hiatal hernia.
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