Ligamentum Teres Augmentation for Hiatus Hernia Repair After Bariatric Surgery: A Systematic Review and Meta-analysis.

IF 1.1 4区医学 Q3 SURGERY Surgical Laparoscopy, Endoscopy & Percutaneous Techniques Pub Date : 2024-08-01 DOI:10.1097/SLE.0000000000001295

Shahrukh Chaudhry, Soroush Farsi, Hayato Nakanishi, Chetan Parmar, Omar M Ghanem, Benjamin Clapp

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Abstract

Objective: Hiatal hernia (HH) and symptomatic gastroesophageal reflux disease are common complications after metabolic bariatric surgery. This meta-analysis aims to investigate the safety and efficacy of ligamentum teres augmentation (LTA) for HH repair after metabolic and bariatric surgeries (MBS).

Materials and methods: CENTRAL, Embase, PubMed, and Scopus were searched for articles from their inception to September 2023 by 2 independent reviewers using the Preferred Reporting Items for Systematic Reviews and Meta-analysis system.

Results: Five studies met the eligibility criteria, with a total of 165 patients undergoing LTA for HH repair after MBS. The distribution of patients based on surgical procedures included 63% undergoing sleeve gastrectomy, 21% Roux-en-Y gastric bypass, and 16% having one anastomosis gastric bypass. The pooled proportion of reflux symptoms before LTA was 77% (95% CI: 0.580-0.960; I2 = 89%, n = 106). A pooled proportion of overall postoperative symptoms was 25.6% (95% CI: 0.190-0.321; I2 = 0%, n = 44), consisting of reflux at 14.5% (95% CI: 0.078-0.212; I2 = 0%, n = 15). The pooled proportion of unsuccessful LTA outcomes was 12.5% (95% CI: 0.075-0.175; I2 = 0%, n = 21).

Conclusion: Our meta-analysis demonstrated that LTA appears to be a safe and efficacious procedure in the management of HH after MBS.

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减肥手术后用于裂孔疝修复的韧带增强术：系统性回顾和元分析。

目的：贲门疝（HH）和无症状胃食管反流病是代谢减肥手术后常见的并发症。本荟萃分析旨在研究新陈代谢减肥手术（MBS）后采用韧带增强术（LTA）修复食管裂孔疝的安全性和有效性：由两名独立审稿人采用系统综述和荟萃分析首选报告项目系统对CENTRAL、Embase、PubMed和Scopus上从开始到2023年9月的文章进行检索：5项研究符合资格标准，共有165名患者在MBS术后接受了LTA进行HH修复。根据手术方式划分，63%的患者接受袖带胃切除术，21%接受Roux-en-Y胃旁路术，16%接受单吻合胃旁路术。LTA前出现反流症状的总比例为77%（95% CI：0.580-0.960；I2 = 89%，n = 106）。总体术后症状的汇总比例为 25.6%（95% CI：0.190-0.321；I2 = 0%，n = 44），其中反流症状占 14.5%（95% CI：0.078-0.212；I2 = 0%，n = 15）。LTA不成功的汇总比例为12.5% (95% CI: 0.075-0.175; I2 = 0%, n = 21)：我们的荟萃分析表明，LTA似乎是治疗MBS后HH的一种安全有效的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 医学-外科

CiteScore

2.00

自引率

10.00%

发文量

103

审稿时长

3-8 weeks

期刊介绍： Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.