The Value of Combination of Laparoscopic Nissen’s Fundoplication with Laparoscopic Greater Curvature Plication in Obese Patient with Gastroesophageal Reflux Disease

Document Type : Original Article

Authors

Department of General Surgery, Faculty of Medicine, Cairo University, Egypt

Abstract

Introduction: Gastroesophageal reflux disease (GERD) and obesity are commonly associated. Resistant GERD
is mainly treated surgically with laparoscopic antireflux surgery, including laparoscopic Nissen fundoplication
(LNF). Bariatric surgery has been recognized as the only definitive treatment for sustained weight loss. A recent
combination of LNF and gastric plication has been proposed for the treatment of GERD and obesity in one setting.
Aim of work: This study aimed to present our experience in performing combined LNF and laparoscopic greater
curve plication (LGCP) for patients with obesity and associated GERD.
Patients and methods: This is a prospective non-randomized cohort study that included patients who underwent
LNF with LGCP for the treatment of obesity and GERD. The patients were followed up for 6 months postoperatively,
during which they underwent clinical assessment of the weight loss, upper GIT endoscopy, and GERD-Health
Related Quality of Life (GERD-HRQL) questionnaire assessment.
Results: This study included 24 patients who were eligible for the study. Perioperative adverse events were
encountered in two patients. One case indicated surgical intervention (4.17%). There were no mortality cases. At
the 6-month follow-up, the mean amount of weight loss was 25.7 ± 13.3 kg, and the mean percentage of total
weight loss was 22.49 ± 0.12. There was statistically significant postoperative improvement in the postoperative
endoscopic findings and GERD-HRQL scores (p<0.001).
Conclusion: This study shows promising short-term efficacy of combined LNF and LGCP for the treatment of
obesity with associated GERD. There are still concerns regarding the standardization of plication techniques.

Keywords

Ain Shams Journal of Surgery
Volume 17, Issue 2
April 2024
Pages 141-147

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