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Residual fundus or neofundus after laparoscopic sleeve gastrectomy: is fundectomy safe and effective as revision surgery?
- Source :
- Surgical Endoscopy; October 2015, Vol. 29 Issue: 10 p2899-2903, 5p
- Publication Year :
- 2015
-
Abstract
- Up to 30 % of patients who have undergone laparoscopic sleeve gastrectomy require revision surgery for inadequate weight loss, weight regain, and/or the development of severe upper gastrointestinal symptoms. The aim of this retrospective study was to evaluate the safety and efficacy of laparoscopic fundectomy (LF) in cases of a residual fundus/neofundus development regarding GERD symptoms. The study group comprised 19 patients (17 female; mean BMI 35.4 kg/m2) divided into 2 groups. Group A (n= 10) patients with severe GERD and evidence of residual fundus/neofundus, Hiatal hernia with good results in terms of weight loss. Group B (n= 9) patients with severe GERD, a residual fundus/neofundus, inadequate weight loss or weight regain. Fundectomy was indicated when a residual fundus/neofundus was associated with severe GERD symptoms. The presence of a residual fundus/neofundus was assessed by a barium swallow and/or multislice computed tomography. No mortality or intra-operative complications occurred. Five postoperative complications occurred: 2 cases of bleeding, 1 mid-gastric stenosis and 2 leaks (10.5 %). All patients experienced improvements in their GERD symptoms and stopped PPI treatment. Group B exhibited an additional %EWL of 53.4 % at 24 months. LF and cruroplasty is feasible and has good results in terms of GERD symptoms control and additional weight loss. The high rate of postoperative complications observed in this series remains a matter of concern. A re-sleeve procedure might be considered as an alternative to RYGB/DS conversion restricted to selected patients.
Details
- Language :
- English
- ISSN :
- 09302794 and 14322218
- Volume :
- 29
- Issue :
- 10
- Database :
- Supplemental Index
- Journal :
- Surgical Endoscopy
- Publication Type :
- Periodical
- Accession number :
- ejs34358118
- Full Text :
- https://doi.org/10.1007/s00464-014-4017-5