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In terms of improvement of reflux symptoms in GERD patients, transoral fundoplication/sleeve gastrectomy is at least comparable to laparoscopic Roux-en-Y gastric bypass.
In the early resolution or decrease of reflux symptoms at 12-15 months, irrespective of body mass index (BMI) reduction, a prospective cohort trial showed that transoral fundoplication/sleeve gastrectomy (TF/SG) is at least similar to laparoscopic Roux-en-Y gastric bypass (LRYGB). Researchers wanted to investigate how TF before SG affected individuals with gastroesophageal reflux disease (GERD) compared to LRYGB.
Overall, 30 consecutive bariatric surgery individuals with GERD underwent TF before SG (TF/SG), and 15 underwent LRYGB. The GERD Health-Related Quality of Life (HRQL) and Reflux Symptom Index (RSI) surveys were used to evaluate symptoms utilizing both subjective and objective criteria. Preoperatively, post-TF/pre-SG, 4-6, and 12–15 months after the bariatric operation, collection of surveys was done.
The following were the preoperative mean scores: Proton pump inhibitor (PPI) use was 93%, satisfaction rate was 6.5%, HRQL was 32.53, and RSI was 21.7. The mean BMI was 45.99 for TF/SG and 42.27 for LRYGB. Table 1 depicts the results for TF/SG and LRYGB at 12 to 15 months after surgery:
Postoperatively, the HRQL-RSI significantly improved in both groups. PPI utilization was 34% (LRYGB) and 13% (TF/SG). BMI decreased by 31% (LRYGB) and 24% (TF/SG). Compared to LRYGB, TF/SG offers greater patient satisfaction and more symptom relief. Without the complication risk associated with LRYGB, TF/SG is a potential alternative to treat both GERD and obesity because of its equivalent benefits in terms of safety profile, and similar outcomes linked with weight reduction and improvement in reflux.
Obesity Surgery
Preliminary Results of a Study Comparing Pre-sleeve Endoscopic Fundoplication to Gastric Bypass on Gastroesophageal Reflux Disease Outcomes
Marc Antonetti et al.
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