Treating Severe GERD and Obesity with a Sleeve Gastrectomy with Cardioplication and a Transit Bipartition.

Abstract:

INTRODUCTION:Epidemiological data have demonstrated that obesity is an important risk factor for the development of gastroesophageal reflux disease (GERD). The proportion of subjects with GERD symptoms can be as high as 50% for BMI > 30. Although still controversial in the literature, there are several studies associating sleeve gastrectomy (SG) with an increase in GERD prevalence. The current video shows the technique of a SG with cardioplication associated with transit bipartition (TB) for the treatment of an obese patient with severe GERD. CASE REPORT AND MANAGEMENT:A 46-year-old male presented with obesity and GERD symptoms for several years. His BMI was 37.8 kg/m2 with mainly central obesity and several obesity-related comorbidities, including hypertension, dyslipidemia, severe insulin resistance, and obstructive sleep apnea. After a diagnostic evaluation, the patient was submitted to a sleeve gastrectomy with a transit bipartition. He presented satisfactory weight loss, reaching a BMI of 26 and remission of all comorbidities and complete remission of GERD symptoms. The current follow-up period is 2.5 years and the patient did not present any weight regain or return of the GERD symptoms. CONCLUSION:We presented a surgical alternative that is effective in both weight loss and remission of GERD. SG + TB is a potent intervention for metabolic syndrome and obesity. Furthermore, this alternative is capable of treating both obesity and GERD, in a simple way, avoiding mechanical restriction and the significant malabsorption related to excluded segments.

journal_name

Obes Surg

journal_title

Obesity surgery

authors

Santoro S,Mota FC,Aquino CG

doi

10.1007/s11695-019-03752-4

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

1439-1441

issue

4

eissn

0960-8923

issn

1708-0428

pii

10.1007/s11695-019-03752-4

journal_volume

29

pub_type

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