Laparoscopic Sleeve-Fundoplication for Morbidly Obese Patients with Gastroesophageal Reflux: Systematic Review and Meta-analysis.
Anterior fundoplication
GERD
Laparoscopic sleeve gastrectomy
Nissen fundoplication
Posterior fundoplication
Journal
Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
23
11
2020
accepted:
21
12
2020
revised:
08
12
2020
pubmed:
4
1
2021
medline:
20
4
2021
entrez:
3
1
2021
Statut:
ppublish
Résumé
Laparoscopic sleeve gastrectomy (LSG) has rapidly become popular with excellent results. However, LSG may exacerbate or increase the risk of "de novo" gastroesophageal reflux disease (GERD). Adding a fundoplication has been proposed to increase the lower esophageal sphincter competency. The aim of this study was to examine the current evidence and outcomes of sleeve-fundoplication (Sleeve-F). Systematic review and meta-analysis. Web of Science, PubMed, and Embase data sets were consulted. Six studies (485 patients) met the inclusion criteria. The age of the patient population ranged from 17 to 72 years old and 82% were females. All patients underwent sleeve-fundoplication. Rossetti, Collis-Nissen, and Nissen were the most commonly performed fundoplications. The estimated pooled prevalence of postoperative leak, gastric perforation, and overall complications were 1.0% (95% CI = 0.0-2.0%), 2.9% (95% CI = 0.0-8.3%), and 9.8% (95% CI = 6.7-13.4%), respectively. The pooled reoperation rate was 4.1% (95% CI = 1.3-10%). There was no mortality. At 12-month follow-up, the estimated pooled BMI and %EWL were 29.9 kg/m This systematic review and meta-analysis shows that current evidence for Sleeve-F is limited with high postoperative gastric perforation and overall complication rates. Weight loss and GERD resolution seem promising in the short term; however, further studies are warranted to explore long-term effects with instrumental investigations. Sleeve-F should be considered cautiously while future well-structured randomized trials are warranted.
Identifiants
pubmed: 33389630
doi: 10.1007/s11695-020-05189-6
pii: 10.1007/s11695-020-05189-6
pmc: PMC8012327
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1714-1721Commentaires et corrections
Type : ErratumIn
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