LNFGP took significantly longer time to perform, but resulted in significantly higher weight reduction and remission/improvement of comorbidities. Both procedures produced similar anti-reflux effect.
Aims: to compare antireflux and bariatric effect of fundoplication by Floppy-Nissen with fundoplication in combination with gastroplication.Methods. Laparoscopic Surgery for severe obesity combined with gastroesophageal reflux disease. A pilot randomized two-arm controlled clinical study was conducted by comparison of standard Nissen fundoplication (LFN) on one side and plication of greater gastric curvature combined with Nissen fundoplication on the other side (LFN+LGP). The study included 114 patients with gastroesophageal reflux disease with BMI of 30-39.9 kg/m2. The following indices were used for efficiency criteria: 24-hour pH measurement with calculation of DeMeesster index, percentage of excess body weight reduction, and patients' life quality evaluation, for which Bariatric analysis and reporting outcome system (BAROS) with Moorehead -Ardelt Quality of Life Questionnaire IIscoring key was used. Postoperative evaluation of life quality and dynamic of key GERD symptoms was conducted by GERD-HRQL questionnaire.Results. All operations were performed laparoscopically. Deaths and severe complications in both groups were not observed. The average time of hospital stay in both groups amounted to 4.291 ± 0.53 (P <0.0001). Antireflux function after surgery was without significant statistical differences. Bariatric effect was better in the first group (LFN + LGP) EWL72.99 ± 10.86, and EWL24.17 ± 8.8 (P <0.0001) in the second. A year after surgery BMI was 27.44 ± 1.56 in the first group, and 32.31 ± 1.95 (P <0.0001) in the second.Conclusions. The proposed laparoscopic surgical method is applicable for simultaneous treatment of obesity in conjunction with gastroesophageal reflux disease. Antireflux efficiency of the proposed restrictive gastroplication combined with fundoplication is identical to properties of standard Nissen fundoplication.Keywords: Gastroesophageal reflux disease -obesity -Nissen fundoplication -great curvature gastricplication. Әдістері. Семіздік пен аралас гастроэзофагеалды рефлюксты ауруды (ГЭРА) лапароскопиялық хирургиялық жолмен емдеу. Рандомизирленген екі жақты зерттеу: бір жағынан стандартты Nissen фундопликациясын (LFN), екінші жағынан Nissen фундопликациясына асқазанның үлкен иірімінің пликациясын үйлестіріп (LFN + LGP) жасаған операцияларды салыстыру. Зерттеуге 30-дан 39,9 кг/м2 дене салмағының индексі (ДСИ) бар гастроэзофагеалды рефлюкс ауруымен ауыратын 114 науқас енгізілді. Операциялардың тиімділігін бағалауда келесі көрсеткіштер пайдаланылдды: тәуліктік рН метрия, DeMeester индексін есептеу, артық салмақтың пайыздық жоғалтуы, науқастардың өмір сүру сапасын бағалау үшін Bariatric analysis and reporting outcome system (BAROS) with Moorehead-Ardelt Quality of Life Questionnaire II scoring key сауалнамасы, операциядан кейінгі гастроэзофагелды рефлюксті ауруға жасалған операциядан кейінгі науқастардың өмір сүру сапасы мен осы аурудың негізгі белгілерінің динамикасын анықтауда GERD-HRQL сауалнамалары қолданылды.Нәтижелері. Барлық операциялар лапароскопиялық жолмен жасалды. Екі топт...
The purpose of the study: to evaluate the efficacy of laparoscopic greater curvature gastric plication in the treatment of type 2 diabetes.Methods. The study involved 32 patients suffering from type 2 diabetes and obesity on average 6.87 ± 1.9 years.Results. Participants in a year lost an average weight of 25 kg. Fasting glucose levels dropped significantly within six months after the operation, which correlates with the trend in the weight loss during this period. The average HbA1c for the cohort gradually decreased during the study period from 9.8% to 5.6%. Much of this change occurred during the first six months. Diabetes Remission was achieved in 92% of patients. In patients with remission, hypoglycemic agents were canceled after 4-22 weeks after surgery.Conclusions. Laparoscopic greater curvature gastric plication lowest altering the physiology of the gastrointestinal tract, lowers blood glucose levels in patients suffering from type 2 diabetes and obesity.
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