{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T02:45:32Z","timestamp":1777776332094,"version":"3.51.4"},"reference-count":16,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:00:00Z","timestamp":1629936000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Introduction.<\/jats:bold>\n                    Laparoscopic sleeve gastrectomy (LSG) is a popular weight loss surgery technique, but the impact on esophageal physiology and esophagogastric junction is still debatable. The aim of our study was to evaluate the manometric changes of the lower esophageal sphincter (LES) after LSG in order to indicate LES manometry pre- procedure.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods.<\/jats:bold>\n                    In a prospective study we evaluated clinically, with upper gastrointestinal endoscopy, and high-resolution esophageal manometry 45 morbidly obese patients before, and 6\u201312 months after LSG.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results.<\/jats:bold>\n                    The BMI (body mass index) decreased from 46.28\u00b15.79 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    to 32.28\u00b14.65 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    postoperatively (p &lt;0.01), with a reduction of ~14 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    of BMI, 39.9 (\u00b111.9) kg body weight and 29.9 (\u00b1 6.2)% of the TWL (Total Weight Loss index), in a median interval of 7.9 months. Gastroesophageal reflux disease (GERD) prevalence increased from 17.8% to 31.1% postoperatively, with new GERD onset in 22.2%, but mild symptomatology (the median GERD-HRQL score increased from 1.56 to 2.84 points). Postoperatory reflux was associated with lower esophageal sphincter (LES) hypotonia, shortening of LES length and IIGP (increased intragastric pressure). Hiatal hernia repair rate was 17.8%, and proton pump inhibitor consumption 20%. After weight loss, the 10 cases of esophagitis discovered preoperatively cured, but 3 patients were diagnosed with de novo esophagitis. The prevalence of manometric dysmotility after LSG was 28.9%, lower than before surgery (44.4%).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion.<\/jats:bold>\n                    Even if GERD remains the main limitation of LSG, the high-resolution esophageal manometry has proved useful and should be implemented in morbidly obese evaluation protocol, to better select the bariatric procedure.\n                  <\/jats:p>","DOI":"10.2478\/rjim-2021-0008","type":"journal-article","created":{"date-parts":[[2021,4,6]],"date-time":"2021-04-06T05:55:56Z","timestamp":1617688556000},"page":"296-302","source":"Crossref","is-referenced-by-count":2,"title":["Impact of laparoscopic sleeve gastrectomy on esophageal physiology"],"prefix":"10.2478","volume":"59","author":[{"given":"Andrada-Loredana","family":"Popescu","sequence":"first","affiliation":[{"name":"Department of Gastroenterology , \u201cDr. Carol Davila\u201d Emergency University Central Military Hospital , Bucharest , Romania"},{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy , Bucharest , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florentina","family":"Ioni\u0163a-Radu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology , \u201cDr. Carol Davila\u201d Emergency University Central Military Hospital , Bucharest , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Jinga","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology , \u201cDr. Carol Davila\u201d Emergency University Central Military Hospital , Bucharest , Romania"},{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy , Bucharest , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasile -Daniel","family":"Balaban","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology , \u201cDr. Carol Davila\u201d Emergency University Central Military Hospital , Bucharest , Romania"},{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy , Bucharest , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raluca-Simona","family":"Costache","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology , \u201cDr. Carol Davila\u201d Emergency University Central Military Hospital , Bucharest , Romania"},{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy , Bucharest , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florin","family":"S\u0103vulescu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology , \u201cDr. Carol Davila\u201d Emergency University Central Military Hospital , Bucharest , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Fierbin\u0163eanu-Braticevici","sequence":"additional","affiliation":[{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy , Bucharest , Romania"},{"name":"Department of Gastroenterology , University Hospital Bucharest , Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2021,8,26]]},"reference":[{"key":"2026042914161174642_j_rjim-2021-0008_ref_001","doi-asserted-by":"crossref","unstructured":"1. 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CHOPRA A., CHAO E., ETKIN Y, MERKLINGER L., LIEB J., DELANY H. Laparoscopic sleeve gastrectomy for obesity: can it be considered a definitive procedure? Surg Endosc 2012;26:831\u2013837.","DOI":"10.1007\/s00464-011-1960-2"},{"key":"2026042914161174642_j_rjim-2021-0008_ref_013","doi-asserted-by":"crossref","unstructured":"13. BRAGHETTO I., CSENDES A., LANZARINI E., PAPAPIETRO K., C\u00c1RCAMO C., MOLINA JC. Is laparoscopic sleeve gastrectomy an acceptable primary bariatric procedure in obese patients? Early and 5-year postoperative results. Surg Laparosc Endosc Percutan Tech. 2012;22(6):479\u2013486.10.1097\/SLE.0b013e318262dc2923238373","DOI":"10.1097\/SLE.0b013e318262dc29"},{"key":"2026042914161174642_j_rjim-2021-0008_ref_014","doi-asserted-by":"crossref","unstructured":"14. KEIDAR A., APPELBAUM L., SCHWEIGER C., ELAZARY R., BALTASAR A. Dilated upper sleeve can be associated with severe postoperative gastroesophageal dysmotility and reflux. 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