Hiatal hernia repair during laparoscopic sleeve gastrectomy: systematic review and meta-analysis on gastroesophageal reflux disease symptoms changes

Introduction: Obesity is associated with a higher prevalence of various comorbidities including gastroesophageal reflux disease (GERD). It is yet still unclear whether laparoscopic sleeve gastrectomy (LSG) exacerbates or alleviates GERD symptoms. Available date in the literature on LSG influence on GERD are contradictory. Aim: This study aimed to systematically review literature comparing the influence of HHR on GERD in comparison to LSG alone. Material and methods: The review was conducted in January 2021 in accordance to PRISMA guidelines. Inclusion criteria involved reporting GERD and comparison of above-mentioned techniques. Primary outcome of interest were alleviation of GERD and “de-novo” GERD symptoms. Secondary outcomes were operative time and morbidity. Results: Initial search yielded 831 records. After the review and full-text screening 5 studies were included in the analysis. There were no differences in terms of GERD outcomes, p = 0.74 for alleviation, p = 0.77 for new symptoms. Concomitant hiatal hernia repair significantly prolongs sleeve gastrectomy by 38 mins. Conclusion: There are no differences in GERD between hiatal hernia repair during sleeve gas