Evaluation of the effectiveness of the antireflux mechanism of the modified technique of laparoscopic longitudinal gastrectomy with the formation of a three-chamber gastric sleeve in patients with morbid obesity

Abstract

INTRODUCTION. The issues of prevention of postoperative gastroesophageal reflux in patients undergone laparoscopic sleeve gastrectomy (LSG) is the most relevant, due to the increase in the number of these surgical interventions and patients who note manifestations of gastroesophageal reflux disease (GERD) in the long-term period after surgery. The OBJECTIVES was to evaluate the effectiveness of the antireflux mechanism of our proposed modified method of laparoscopic longitudinal gastrectomy with the formation of a three-chamber gastric «sleeve». METHODS AND MATERIALS. The study was based on the data from clinical examination of patients with morbid obesity, who were operated on in the NHI «Railway Clinical Hospital» at the Rostov-Glavnyi station in 2008-2019. We made comparisons of the clinical manifestations of GERD before and after surgery in patients who underwent LSG using classic and modified technique. RESULTS. As a result of the study, we were able to identify that a year after both types of operations, patients showed an increase in GERD symptoms. And in 47 % of all operated, GERD appeared de novo. However, we managed to fix the difference between the frequency of occurrence of reflux in the studied groups. Thus, a year after the operation, in the control group, the clinical manifestations of reflux increased by 25 %, both in qualitative and quantitative indicators. While in the study group, these manifestations were increased by 13.5 %. CONCLUSION. The use of the antireflux surgery of prostate cancer proposed by us in patients with morbid obesity significantly improves their quality of life with symptoms of GERD and can be used in patients with existing GERD symptoms before surgery and without them.