Abstract
BackgroundLaparoscopic sleeve gastrectomy (LSG) has become a single-step operation for the management of severe obesity. A statistically significant number of participants who undergo this procedure experience nausea, vomiting, and reflux symptoms early after the operation. The objectives of this study were to measure the positive or negative effect of gastropexy on reducing distressing postoperative LSG-related gastrointestinal symptoms.Patients and MethodsThis was a comparative randomized study conducted from January 2018 to January 2021. The study was carried out in the general surgery department at Menoufia University Hospital, Menoufia Faculty of Medicine in Egypt. Two hundred participants were included randomly during this trial. The participants were divided into two groups, with 100 patients in each group. Patients in group A underwent gastropexy, and patients in group B underwent LSG without gastropexy.ResultsThere was no significant difference between the groups in age or sex (p > 0.05). There was no significant difference in the length of hospital stay (p > 0.05). There was a significant difference between the two groups regarding nausea, vomiting, reflux symptoms, and the amount and frequency of antiemetics used (p < 0.001). There was also a significant difference in hospital readmissions (p < 0.05) and in clinic visits during the postoperative period.ConclusionsPatients who underwent gastropexy showed a significant reduction in antiemetic consumption and a significantly lower incidence of postoperative nausea, vomiting, gastroesophageal reflux disease symptoms and gastric torsion than those who did not undergo gastropexy.Graphical abstract
Highlights
In 1993, Marceau described sleeve gastrectomy, which aims to promote weight loss, as a component of biliopancreatic diversion [1]
Patients may complain of significant nausea within the follow-up period, which leads to additional clinic visits, telephone encounters, and readmissions [7]
Mathus-Vliegen reported that the loss of gastric fixation along its previous natural axis along the greater curve could be an explanation for early postoperative nausea, retching, vomiting, and reflux symptoms [18]
Summary
In 1993, Marceau described sleeve gastrectomy, which aims to promote weight loss, as a component of biliopancreatic diversion [1]. Excitation of old or new gastroesophageal reflux and anorexia are the most common complications after LSG These complications may have considerable effects on quality of life and may require conversion to another operation, such as Roux-en-Y gastric bypass (RYGB) [8]. Some trials have reported that loss of gastric fixation could lead to improper positioning of the sleeved stomach, causing permanent gastroesophageal reflux and anorexia [9]. Conclusions Patients who underwent gastropexy showed a significant reduction in antiemetic consumption and a significantly lower incidence of postoperative nausea, vomiting, gastroesophageal reflux disease symptoms and gastric torsion than those who did not undergo gastropexy
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