Talha A, et al. – This study was planned to prove the safety and feasibility of laparoscopic Nissen’s fundoplication (LNF) combined with mid–gastric plication (MGP) for treatment of obese patients with Gastroesophageal reflux disease (GERD). Findings suggested that LNF combined with MGP for treatment of obese patients with GERD was technically safe, feasible, and promising with no serious procedure–related complications. The technique proved efficacious regarding weight loss and cure of GERD. However, future larger studies were recommended to establish the safety, effectiveness, and long–term durability of the procedure.

Methods

• 18 patients underwent LNF combined with MGP. Authors performed all interventions under general anesthesia.
• They assessed body mass index (BMI), percentage of excess weight loss (%EWL), percentage of excess BMI loss (%EBMIL), and clinical assessment using the Gastro-esophageal Reflux Health-Related Quality-of-Life (GERD-HRQOL) scale as per the follow-up protocol at 6 and 12 months.

Results

• The patients were followed-up for a mean period of 17.74 ± 3.73 months (ranged from 12 to 33 months).
• The operation time was 1.40 ± 0.27 h.
• Authors identified no serious procedure-related complications.
• All patients indicated resolution of GERD-related symptoms (p < 0.001).
• Observations revealed a significant improvment in endoscopic findings at 6 months compared to properatively (p = 0.001).
• A significant patient satisfaction score using GERD-HRQOL at 6 and 12 months (p = 0.000) was observed.
• The 1-year follow-up indicated that excess weight was significantly less than the baseline excess weight (p < 0.001).
• A decrease in the average BMI was observed from 37.59 ± 1.89 kg/m² at baseline to 30.61 ± 1.57 kg/m² at 1 year (p < 0.001).