Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2017
Laparoscopic sleeve gastrectomy combined with Rossetti fundoplication (R-Sleeve) for treatment of morbid obesity and gastroesophageal reflux.
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Olmi Stefano, Caruso Francesco, Uccelli Matteo, Cioffi Stefano, Ciccarese Francesca, Cesana Giovanni
Аннотация
BACKGROUND: Gastroesophageal reflux (GERD) can be considered an obesity-related disease. Roux-en-Y gastric bypass is considered the gold standard for its therapeutic effects on acid reflux.
OBJECTIVES: The aim of this retrospective study is to assess the effectiveness of combined laparoscopic sleeve gastrectomy and Rossetti antireflux fundoplication for the treatment of morbidly obese patients with GERD.
SETTING: A private academic hospital in Italy.
METHODS: Forty obese patients with GERD underwent laparoscopic sleeve gastrectomy-Rossetti laparoscopic fundoplication from January 1 to October 31, 2015. A specific informed consent was obtained. Minimum follow-up was 12 months. No cases were lost to follow-up.
RESULTS: Mean body mass index was 44.4 ± 4.7 kg/m2; all patients had GERD. Mean operative time was 38 ± 6 minutes. The mortality rate was 0%. No intraoperative or medium- or long-term complications were reported. Excess weight loss percent at 1, 3, 6, 12 months was 25.6 ± 6.1, 41.9 ± 12.5, 56.7 ± 13.0, 61.7 ± 13.6, respectively. Excess body mass index loss percent at 1, 3, 6, 12 months was 29.3 ± 3.4, 47.2 ± 5.2, 64.0 ± 8.6, 73.3 ± 9.9, respectively. At the 12-month follow-up visit, 95% of the patients reported a good sense of repletion without episodes of vomiting, nausea, or dysphagia.
CONCLUSIONS: Rossetti laparoscopic fundoplication is well tolerated, feasible, and safe in obese patients with GERD, with good postoperative weight results. Following this evidence, 2 monocentric prospective and randomized studies will start to analyze and confirm the reported data.
OBJECTIVES: The aim of this retrospective study is to assess the effectiveness of combined laparoscopic sleeve gastrectomy and Rossetti antireflux fundoplication for the treatment of morbidly obese patients with GERD.
SETTING: A private academic hospital in Italy.
METHODS: Forty obese patients with GERD underwent laparoscopic sleeve gastrectomy-Rossetti laparoscopic fundoplication from January 1 to October 31, 2015. A specific informed consent was obtained. Minimum follow-up was 12 months. No cases were lost to follow-up.
RESULTS: Mean body mass index was 44.4 ± 4.7 kg/m2; all patients had GERD. Mean operative time was 38 ± 6 minutes. The mortality rate was 0%. No intraoperative or medium- or long-term complications were reported. Excess weight loss percent at 1, 3, 6, 12 months was 25.6 ± 6.1, 41.9 ± 12.5, 56.7 ± 13.0, 61.7 ± 13.6, respectively. Excess body mass index loss percent at 1, 3, 6, 12 months was 29.3 ± 3.4, 47.2 ± 5.2, 64.0 ± 8.6, 73.3 ± 9.9, respectively. At the 12-month follow-up visit, 95% of the patients reported a good sense of repletion without episodes of vomiting, nausea, or dysphagia.
CONCLUSIONS: Rossetti laparoscopic fundoplication is well tolerated, feasible, and safe in obese patients with GERD, with good postoperative weight results. Following this evidence, 2 monocentric prospective and randomized studies will start to analyze and confirm the reported data.