Laparoscopic gastric greater curvature plication in the treatment of obesity long-term results. Gastric plication

Abstract

Background: Laparoscopic gastric greater curvature plication (LGGCP) is a novel bariatric procedure. Few studies have presented intermediate or long-term results. The aim of this prospective study was to investigate intermediate results after LGGCP. Methods: Between October 2011 and November 2013, 61 patients underwent LGGCP and were followed up to 54 months after operation. Demographics, comorbidities, complications, and percentage of excess body mass index loss (%EBMIL) were analyzed. Logistic regression analysis was used to determine independent risk factors for weight loss failure after LGGCP. Results: Forty-eight women and 13 men with an average age of 47.7 ± 10.3 years and preoperative BMI of 46.3 ± 5.8 underwent LGGCP. Follow-up rate was 95%, 91.7%, 88.3% and 85% after 1, 2, 3 and 4 years, respectively. Average %EBMIL after 1 year was 47.25 ± 21.6, 44.8 ± 25.9 after 2 years, 41.9 ± 25.6 after 3 years, and 35.99 ± 28.03 after 4.5 years. Gastroscopy 3 years after LGGCP demonstrated intact plication fold in 55% of cases. Preoperatively GERD was present in 46% of patients. Prevalence of GERD 3 years after LGGCP was 34.6%. Remission rate of type 2 diabetes mellitus and hypertension were 27.8% and 38.3%, respectively. Higher postoperative hunger sensation was found to be an independent factor (OR 1.6, 95% 1.141-2.243; p=0.002) associated with unsatisfactory weight loss after LGGCP. Conclusions: Intermediate results after LGGCP is similar to those achieved by gastric banding operation. Long-term follow-up data are needed to define the role of LGGCP in the treatment of morbid obesity.