Abstract

Objective: The aim of this study was to evaluate the Laparoscopic Sleeve Gastrectomy (LSG) with simultaneous crural repair in treatment of morbid obesity associated with gastroesophageal reflux disease. 

Methods: This prospective observational study was carried out from September 2012 to July 2016 in Al-Azhar University Hospital (Egypt). The study was conducted on 53 patients, 14 males (26.4%) and 39 females (73.6%) with the mean age 36.2 years (range 18-52 years), presenting with morbid obesity and reflux disease either symptomatic patients or asymptomatic (Endoscopic & Manometric), their mean Body Mass Index (BMI) was 50.1 kg/m2 (range 40-62 kg/m2), who underwent LSG and antireflux procedure (crural repair). 

Results: Excess weight Loss (EWL); the mean EWL at 6 months postoperatively was 46.3%, at 12 months was 54%, and at 18 months was 61%. Also, we found that, preoperative co-morbidities are resolved by 53% and improved by 23%. Reflux symptoms were absent in 30 patients (56 %), improved in 14 patients (26.4 %), but persistent in 7 patients (13.2 %). 

Conclusion: Laparoscopic crural closure, during LSG, represents a valuable option for the treatment of morbid obesity and gastroesophageal reflux, and can result in favorable outcomes in terms of weight loss and gastroesophageal reflux disease (GERD) symptoms control.

 

Keywords: Morbid obesity, Reflux esophagitis, Sleeve gastrectomy, Hiatal repair, Weight loss
 
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