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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Gastric greater curvature plication combined with Nissen fundoplication in the treatment of gastroesophageal reflux disease and obesity

1
Department of Endoscopic Surgery, Astana Medical University, Astana, Kazakhstan
2
Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
3
Department of Gastrosurgical Research and Education, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
*
Author to whom correspondence should be addressed.
Medicina 2016, 52(5), 283-290; https://doi.org/10.1016/j.medici.2016.08.001
Received: 23 March 2016 / Revised: 8 August 2016 / Accepted: 26 August 2016 / Published: 20 September 2016
Background and aim: Established anti-reflux procedures such as fundoplications are less efficient in obese patients. The aim of this study was to investigate clinical effectiveness of the fundoplication combined with gastric greater curvature plication in the treatment of gastroesophageal reflux disease (GERD) in obese patients.
Materials and methods:
During the period from June 2010 to September 2014, patients operated for GERD with BMI from 30 to 39.9 kg/m2 were included into the prospective study. Laparoscopic Nissen fundoplication (LNF, n = 58) was performed until February 2013 and later laparoscopic Nissen fundoplication was combined with gastric greater curvature plication (LNFGP, n = 56). The groups were compared according to the control of GERD and weight loss.
Results:
In LNF group there were significantly more males, patients had lower BMI and longer duration of GERD symptoms. Duration of surgery was significantly longer in LNFGP group, 96.5 (17.3) min vs. 59.8 (16.1) min (P < 0.0001). Postoperative morbidity was similar, 3.6% and 3.4% in LNFGP and LNF groups, respectively (P = 0.9539). The average percentage of excess BMI loss after 12 months was 45.3 (5.8) in LNFGP group as compared to 18.4 (4.6) in LNF group (P < 0.0001). Significantly more patients experienced remission or improvement of type 2 diabetes mellitus (P = 0.03) and hypercholesterolemia (P = 0.0001) in LNFGP group. No significant differences between the groups in postoperative DeMeester score, GERD-HRQL mean score, overall satisfaction and healing of esophagitis were observed.
Conclusions: LNFGP took significantly longer time to perform, but resulted in significantly higher weight reduction and remission/improvement of comorbidities. Both procedures produced similar anti-reflux effect.
Keywords: Gastroesophageal reflux disease; Obesity; Nissen fundoplication; Gastric greater curvature plication Gastroesophageal reflux disease; Obesity; Nissen fundoplication; Gastric greater curvature plication
MDPI and ACS Style

Ospanov, O.; Maleckas, A.; Orekeshova, A. Gastric greater curvature plication combined with Nissen fundoplication in the treatment of gastroesophageal reflux disease and obesity. Medicina 2016, 52, 283-290.

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