{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T11:28:18Z","timestamp":1764588498626,"version":"3.40.4"},"reference-count":0,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T00:00:00Z","timestamp":1708992000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T00:00:00Z","timestamp":1708992000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Surg Res"],"abstract":"<jats:p>Introduction: \nLaparoscopic sleeve gastrectomy (LSG) is associated with postoperative gastroesophageal reflux disease (GERD) and erosive esophagitis (EE). The role of crural repair during LSG is still controversial. The preoperative laxity of the gastroesophageal junction (GEJ), graded by the Hill\u2019s classification, is more predictive for postoperative GERD and EE after LSG than the presence of a hiatal hernia seen on endoscopy. Thus, the authors hypothesize that a concomitant crural repair in a specific subgroup of patients with a lax GEJ (Hill\u2019s III) may reduce the incidence of postoperative GERD and EE.  \n\nMethods: \nA double-blinded, randomized controlled trial of patients with Hill\u2019s III GEJ undergoing LSG will be randomized to a concomitant crural repair (experimental) versus LSG alone (control). Primary outcome measures will be presence of EE at 1-year. Secondary outcome measures will include proton pump inhibitor use, postoperative complications, operative time, blood loss, quality of life, GERD and gastrointestinal symptoms. \n\nConclusion:\nConflicting crural repair results may be explained by differences in preoperative GEJ laxity. Patients with a frank hiatal hernia and patulous GEJ (Hill\u2019s IV) have a very high, while patients with an apposed GEJ (Hill\u2019s I, Hill\u2019s II) have a low incidence of postoperative GERD and EE respectively. Thus, the authors hypothesize that patients with a lax GEJ without frank hiatal hernia (Hill\u2019s III), might benefit from a crural repair. This study results can potentially highlight the clinical importance of preoperative endoscopic evaluation of the GEJ in all patients planned for LSG, to determine which subgroup patients may benefit from a crural repair. (Clinicaltrials.gov: NCT05330910, Registered 15-April-2022).\n<\/jats:p>","DOI":"10.1159\/000538043","type":"journal-article","created":{"date-parts":[[2024,2,27]],"date-time":"2024-02-27T22:00:34Z","timestamp":1709071234000},"source":"Crossref","is-referenced-by-count":2,"title":["Rationale and Trial Protocol for a Double-Blinded Randomized Controlled Trial to assess the\nImpact of a Concomitant Crural Repair during Laparoscopic Sleeve Gastrectomy in Patients with a\nLax Gastroesophageal Junction without Frank Hiatal Hernia (REPAIR trial protocol)"],"prefix":"10.1159","author":[{"given":"Koy Min","family":"Chue","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin Chet","family":"Toh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lester Wei Lin","family":"Ong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gamage Manisha","family":"Kariyawasam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wai Keong","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chin Hong","family":"Lim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy Tian Hui","family":"Tan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baldwin Po Man","family":"Yeung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2024,2,27]]},"container-title":["European Surgical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/esr\/article-pdf\/doi\/10.1159\/000538043\/4173057\/000538043.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/esr\/article-pdf\/doi\/10.1159\/000538043\/4173057\/000538043.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:09:25Z","timestamp":1745420965000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000538043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,27]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1159\/000538043","archive":["Portico"],"relation":{},"ISSN":["0014-312X","1421-9921"],"issn-type":[{"type":"print","value":"0014-312X"},{"type":"electronic","value":"1421-9921"}],"subject":[],"published":{"date-parts":[[2024,2,27]]}}}