The role of cardioesophageal lipoma in the formation of hiatal hernia in patients after bariatric surgery

Abstract

The purpose of this study was to determine the role of cardioesophageal lipoma in the development of hiatal hernia in patients after bariatric surgery.Material and methods. The research involved three groups of patients: patients with obesity without a hiatal hernia, who subsequently underwent a sleeve gastrectomy (1st group, 54 people); patients with normal body mass index (BMI) and diagnosed hiatal hernia (2nd group, 56 people); patients with normal BMI without hiatal hernia (3nd group, 60 people). The assessment of the area of visceral fat and cardioesophageal lipoma was determined according to the MSCT data of the abdomen. Patients completed a questionnaire using the GERD-HRQL, patients of 1st group (after bariatric surgery) completed a questionnaire using the BAROS.Results and discussion. We noted a higher incidence of cardioesophageal lipoma in obese patients (70.4%). In obese patients after a bariatric procedure, along with a decrease in BMI, not only the area of internal visceral fat, but also the area of cardioesophageal lipoma significantly decreases, which led to the formation of hiatal hernia in 68.75% of patients.Conclusion. The data obtained indicate a high incidence of cardioesophageal lipoma in obese patients. Cardioesophageal lipoma is an important pathogenetic link in the development of hiatal hernia, and, as a result of gastroesophageal reflux, in bariatric patients in the late postoperative period.