Preoperative and postoperative sleeve gastrectomy assessment of the lower esophageal sphincter wi̇th high resoluti̇on manometry (HRM)

Laparoscopic Sleeve Gastrectomy (LSG) operation has become one of the most commonly used treatment options for obesity in today's world. In Sleeve Gastrectomy operation; after releasing the greater curvature from 2-3 cm proximal to the pylorus to the angle of His, stomach resection is performed with staplers. His angle; it is the narrow angle between the esophagus and fundus. This narrow angle and gas-filled fundus ensure that the cardia remains closed. As a result, gastroesophageal reflux is prevented. Releasing the fundus during Sleeve Gastrectomy operation causes disruption of the His angle and thus reflux mechanisms. Therefore, the aim of our study is; In Sleeve Gastrectomy operations performed at Düzce University Faculty of Medicine General Surgery Clinic, preoperative and postoperative High Resulation Manometer (HRM) was used to quantitatively measure Lower Esophageal Sphincter Pressure and reveal the possibility of postoperative reflux. As a result of our study, Lower Esophageal Sphincter Resting Pressure was measured with HRM in 28 preoperative and postoperative patients who underwent LSG. As a result of the measurements, it was observed that the Lower Esophageal Sphincter Pressure decreased in the postoperative period. (p=0.048) There was no statistically significant difference between genders. (p>0.05) However, it was observed that Lower Esophageal Sphincter Pressure decreased statistically more than the BMI decrease rate. (p=0.026) As a result, LSG operations which are performed frequently in today's world, we think that postoperative LSG patients should always be more wathful in order to be protected from reflux and reflux-related complications (such as esophagitis, Barrett's Esophagus) that may develop after. Key Words: Laparoscopic Sleeve Gastrectomy, High Resulation Manometer, Lower Esophageal Sphincter Pressure, Reflux