Laparoscopic Gastric Plication versus Laparoscopic Sleeve Gastrectomy as a Surgical Treatment of Morbid Obesity

摘要

Background: Morbid obesity increases the risk for many associated diseases including hypertension, type II diabetes, and cardiac diseases.The present study aims to compare between laparoscopic vertical sleeve gastrectomy and laparoscopic gastric plication as regarding the feasibility, complication and effectiveness in weight loss. Methods: This is a prospective comparative study conducted between June 2011 and May 2014, which included 60 patients, divided into 2 groups, group (A) included 30 patients (17 females and 13 males) who underwent laparoscopic vertical sleeve gastrectomy (LSG),and group (B) included 30 patients (16 females and 14 males) who underwent laparoscopic gastric plication (LGP). The mean BMI was 42.85±3.8 kg/m2 for group (A) and 41.92±5.7 kg/m2 for group (B). And mean age was 39.5±8.6 years for group (A) and was 40.2±3.6 years for group (B). Follow up for all cases were recorded at 1, 3, 6, and 12 months. The comparison between the 2 groups was done as regarding operative time, complications and percentage of excess weight loss. Results: In the present study, all procedures were done laparoscopically without the need for conversion. There were4 cases showed intra-operative bleeding in LSG group and 3 cases at LGP group. The mean operative time was 78±26 minutes for the LSG group and 90±7.5minutes for the LGP group (P< 0.05). The mean hospital stay was 3.2±1.7days in the LSG group and 3.9±2.3days in the LGP group (P=0.00473). The excess weight loss (EWL) at 1, 3, 6,and 12 months was 19.8%, 30.4%, 48.6%,and 59.4% respectively for LSG group, while in LGP group, it was 18.7%, 28.9%, 45.8%, and 56.6%, respectively. There is no weight regain recorded up to date in all patients. Conclusion: Laparoscopic sleeve gastrectomy (LSG)and laparoscopic gastric placation(LGP), both are gastric restrictive technique for treatment of morbid obesity, but LSG is superior to LGP regarding percentage of EWL and operative time. However, long terms follow up and large prospective randomized controlled studies are still needed.