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Trends in Medical Research
  Year: 2016 | Volume: 11 | Issue: 2 | Page No.: 54-61
 
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Feasibility of Laparoscopic Management of Hiatal Hernia and/or Gastroesophageal Reflux Disease with Laparoscopic Sleeve Gastrectomy or Greater Curvature Plication in Morbidly Obese Patients

Ayman M. Elwan, Mohammed A. Abomera, Almetwaly R. Ibrahim, Nagah S. Atwa, Gaber M. Bakheet, Slah G. Ziada, Omar Alsamahy and Mahmoud A. Abo Al Makarem

Abstract:
Gastro Esophageal Reflux Disease (GERD) presents at high incidence in morbidly obese patients. Laproscopic Sleeve Gastrectomy (LSG) has gained popularity as a definitive bariatric surgical procedure. Laparoscopic Greater Curvature Plication (LGCP) is a new bariatric restrictive procedure. The purpose was to compare between laparoscopic crural repair only with sleeve gastrectomy and laparoscopic Nissen fundoplication with greater curvature plication for management of GERD and/or hiatal hernia in morbidly obese patients. From August, 2013 to July, 2015, 40 morbidly obese patients with hiatal hernia and/or GERD underwent laparoscopic sleeve gastrectomy (Group A) or laparoscopic greater curvature Plication (Group B). After a mean follow-up of 14.1 month, median BMI fallen to 35 in group A and to 37.95 kg m–2 in group B. There was significant increase of operative time in group B when compared to group A (148±19.01 vs 100.75±12.27 min, respectively). On the other hand, the time to resume oral feeding was significantly shorter in group B (25±1.45 vs. 29±1.45 h). In addition, there was significant decrease of GERD symptoms in group B (0.0% vs. 20.0%). However, six patients in group B complaining postoperatively of gastric bloating (subside gradually during follow up period) and nine patients complaining of dysphagia (resolved with medical treatment). In group A, two patients complaining of dysphagia (disappear spontaneously during the follow up period) and recurrence of GERD symptoms reported in four patients (treated with minimal dose of PPI). Preoperatively, there were two patients of group A, who had moderate HH, which became mild postoperatively and no recurrence in group B. Nissen fundoplication with greater curvature plication requires a longer operative time. However, it had extra benefits such as, no alteration of body physiology, low complication rates, low cost, creation of high pressure zone with fundal wrap of Nissen fundoplication and no recurrence was recorded. Laparoscopic nissen fundoplication with greater curvature plication appears to have better results on GERD and/or hiatus hernia when compared to laparoscopic crural repair with sleeve gastrectomy, although it had long operative time.
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How to cite this article:

Ayman M. Elwan, Mohammed A. Abomera, Almetwaly R. Ibrahim, Nagah S. Atwa, Gaber M. Bakheet, Slah G. Ziada, Omar Alsamahy and Mahmoud A. Abo Al Makarem, 2016. Feasibility of Laparoscopic Management of Hiatal Hernia and/or Gastroesophageal Reflux Disease with Laparoscopic Sleeve Gastrectomy or Greater Curvature Plication in Morbidly Obese Patients. Trends in Medical Research, 11: 54-61.

URL: https://scialert.net/abstract/?doi=tmr.2016.54.61

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