Prevention and treatment of gerd in patients with obesity undergoing gastroplication

The aim of the study was to study the advantages and disadvantages of laparoscopic gastric plication with the prevention and treatment of gastroesophageal reflux disease in the treatment of patients with overweight and obesity. From 2018 to the present, 24 patients have been observed who underwent laparoscopic gastric plication with the prevention and treatment of gastroesophageal reflux disease, of which 19 (79.2 %) women and 5 (20.8 %) men. The average age of patients is 41 ± 3.5 years. Indication for surgery: BMI > 35 kg/m² and the presence of GERD with unsuccessful conservative treatment or BMI > 35 kg/m² and the presence of HH with symptoms of GERD. The experience of surgical treatment of these 24 patients allows us to speak about the effectiveness of the use of gastroplication surgery with the prevention and treatment of gastroesophageal reflux disease with a combination of obesity and GERD. Dyspeptic symptoms are expected in some patients and are stopped in the early postoperative period with medication. The return of BMI to baseline in 3 (12.5 %) patients requires further study.

A safety study of laparoscopic single-anastomosis duodeno-ileal bypass with gastric plication (SADI-GP) in the management of morbid obesity

Background Bariatric surgery is more effective in the management of morbid obesity and related comorbidities than is conservative therapy. Pylorus-preserving single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-SG) is a modified duodenal switch technique. Gastric plication (GP) is an alternate to SG. Methods Morbidly obese (BMI of > 40, or > 35 in the presence of diabetes or prediabetes) patients were recruited and operated on to perform SADI with GP. Complications related to surgery were recorded to assess the feasibility of the procedure. Weight-loss outcomes were analysed to determine efficacy. Minnesota Multiphasic Personality Inventory 2 (MMPI-2) was recorded after 1 year of follow-up, and test scales were used to describe physiological phenomena. Results Seventeen middle-aged (mean: 40 years) patients were involved in our study; 15 of them were females. The mean duration of surgery was 205 min. There were no complications of conversion, death, bleeding, VTE or 30-day readmission to hospital. We did experience CD4a (pulmonary insufficiency due to chronic lung disease) and a CD3b (anastomosis leakage treated laparoscopically) complications. Vomiting occurred in three cases (CD1). Obesity-related comorbidities showed favourable resolution rates (77.8% for hypertension, 81.2% for dyslipidaemia, 100% for diabetes at the 1-year follow-up). Weight-loss outcomes were favourable (53.20 EWL%, and 35.58 TWL% at 1-year follow-up). Greater weight loss caused significantly higher levels of Depression (t(13.958) = − 2.373; p = 0.00; p < 0.05) and Low Positive Emotions (t(13.301) = − 2.954; p = 0.00; p < 0.05) and Introversion/Low Positive Emotionality (t(13.408) = − 1.914; p = 0.02; p < 0.05) in MMPI-2 data. Conclusion According to our safety study, SADI-GP is a promising malabsorptive procedure, but a long-term high-volume case series or a randomised controlled trial is necessary to evaluate complication rates and weight-loss outcomes. Emotional dysregulation is common among bariatric surgery patients according to personality inventory data; therefore, psychological follow-up and psychotherapeutic support are necessary for weight-loss maintenance.