A combination of laparoscopic Nissen fundoplication and laparoscopic gastric plication for gastric esophageal reflux disease and morbid obesity

Abstract

Introduction. The gastroesophageal reflux disease (GERD) is common in obesity due to the increased intra-abdominal pressure. This study retrospectively analyzed the combination (LNFGP) of laparoscopic gastric plication (LGP) and laparoscopic Nissen fundoplication (LNF) applied to patients with obesity and GERD. Materials and Methods. The study included patients operated on between January 1st, 2013 and January 1st, 2016. The body mass index (BMI) of the patients was evaluated both preoperatively and postoperatively. The preoperative and postoperative degrees of esophagitis were compared using upper gastrointestinal tract (UGI tract) endoscopy. Additionally, postoperative complications and mortality were evaluated. Results. In this study, resistance and morbid obesity were evaluated for the 123 patients who underwent combined LNF and LGP operation (due to the co-existence of GERD) with the medical treatment. A statistically significant decrease was observed in the BMI after one-year follow-up (p <0.001). Compared to the preoperative period, an improvement was observed in the degree of endoscopic esophagitis at 12 months postoperatively (p<0.001). Conclusions. In case of the co-existence of morbid obesity and GERD, combined LNF and LGP operation is a good option for the treatment of obesity as well as for obesity-related comorbidities, such as GERD.

Keywords

• laparoscopic
• morbid obesity
• nissen
• plication