Does Contouring of the Sleeve Help Prevent de novo GERD after Laparoscopic Sleeve Gastrectomy? A Nonrandomized Study

ABSTRACT

PURPOSE: The authors undertook this study to compare their modified version of sleeve gastrectomy with conventional sleeve gastrectomy in terms of the severity and incidence of gastroesophageal reflux. MATERIALS AND METHODS: This study was conducted for the patients that underwent primary laparoscopic sleeve gastrectomy in a single center from 2011 to 2015. Patients that underwent conventional LSG were allocated to Group A (n=46), and sleeve contouring gastrectomy to Group B (n=45). Postoperatively %EBMIL, PPI use, and endoscopy findings, and receipt of conversion surgery were compared. RESULTS: Age, gender (FM), and baseline BMI in groups A and B were 34.2±10.5 years vs. 30.9±8.9 years (P=0.142), 2818 vs. 3015 (P=0.565), and 36.8±8.9 kg/m² vs. 35.5±5.8 kg/m² (P=0.046), respectively. %EBMIL values at 1 year postoperatively were not different (P=0.946), mean durations of PPI use were 141.2±240.3 (30–1160) days vs. 71.9±24.3 (60–128) days, respectively (P=0.058). Endoscopic findings at 1 year were LA-M in 22/32 (68.8%) vs 19/24 (79.2%), LA-A in 7/32 (21.9%) vs. 5/24 (20.8%), LA-B in 1/32 (3.1%) vs. 0/24 (0.0%), and LA-C in 2/32 (6.3%) vs. 0/24 (0.0%) (P=0.483). Numbers of patients used PPIs over 1 year were 4/46 (8.77%) vs. 0/45 (0.0%) (P=0.043), and conversions to RYGP were 1/46 (2.21%) vs. 0/45 (0.0%), respectively (P=0.320). CONCLUSION: Contouring of the sleeve in LSG in this study might reduce the incidence of de novo GERD without compromising weight loss.