Mini-gastric bypass with Nissen fundoplication for the treatment of obesity and gastroesophageal reflx disease

Abstract

Aim. To develop bariatric and antireflx surgery for the treatment of patients with obesity and GERD, and to assess its effectiveness and safety.Methods. A prospective controlled study included 28 patients who underwent laparoscopic mini-gastric bypass with Nissen fundoplication, and their progress was monitored for three years postoperatively. This study covered the surgical procedure and its technical aspects. Surgical treatment was evaluated using GERD-HRQL, BAROS, and GIQLI questionnaires, as well as instrumental studies (esophagogastroscopy and X-ray of the esophagus and stomach).Results. According to the GERD-HRQL questionnaire, mini-gastric bypass with Nissen fundoplication demonstrated excellent control over GERD symptoms during all stages of postoperative follow-up. The most signifiant reduction in body weight occurred within the fist year after the operation, with sustained effects throughout the observation period. The maximum percentage of excess body weight loss was observed two years post-operation. The GIQLI questionnaire showed an average score increase of 54 % three years after surgical treatment compared to baseline. Evaluation of the bariatric treatment’s effectiveness using the BAROS system criteria consistently indicated «excellent and very good results» throughout the entire postoperative follow-up period. No signifiant postoperative complications were identifid, both in the early and long-term periods.Conclusion.The developed mini-gastric bypass with a Nissen fundoplication proves to be a safe and effective surgical treatment method for patients with obesity and GERD. Following further clinical studies and the analysis of long-term results, the proposed operation could be recommended as an alternative to RYGB and MGB-OAGB for patients with obesity and GERD.