The effect of sleeve gastrectomy on extraesophageal reflux disease

Abstract

BackgroundSleeve gastrectomy (SG) has been linked to increased rates of postoperative gastroesophageal reflux. ObjectiveThe aim of this study was to evaluate whether SG is also linked to increased pulmonary extraesophageal reflux disease in a rodent model, based on histologic inflammatory distal airway changes. SettingUniversity hospital. MethodsWistar rats (Charles River Institute, Wilmington, MA) were fed a high fat diet (HFD) for 4 months. They were divided into HFD only (n = 25) and SG+HFD (n = 19) groups and euthanized at 12 weeks, and the trachea and lungs were harvested en bloc then preserved for analysis by a blinded board-certified pathologist. ResultsRats who underwent SG were significantly less likely to show postmortem distal airway changes (4.0% versus 31.0%, P = .03), had a lower average chronic aspiration pneumonitis grade (.73 versus 1.57, P = .006), and had a lower total lung injury score (1.19 versus 2.28, P = .005). Alveolar hemorrhage was also less common in the SG+HFD group (37.5% versus 80.0%, P = .006). ConclusionSG is associated with increased incidence of normal lung histology on postmortem examination, less evidence of chronic aspiration pneumonitis and alveolar hemorrhage, and decreased total lung injury score in a rodent model. SG appears to have a protective effect on the pulmonary system. This suggests that SG does not exacerbate extraesophageal reflux effects on the pulmonary epithelium.