Outcomes of Nissen sleeve gastrectomy in a short‑term follow‑up: a new future?

TL;DR

This study shows that combining sleeve gastrectomy with Nissen fundoplication effectively reduces GERD and leads to significant weight loss.

Contribution

The study introduces and evaluates a new bariatric procedure combining sleeve gastrectomy with Nissen fundoplication.

Findings

97.1% of patients achieved GERD remission after the procedure.

Patients lost an average of 30.3% of their total weight within 12 months.

Over half of patients experienced remission of hypertension.

Abstract

Sleeve gastrectomy (SG) is the most commonly performed bariatric procedure worldwide, offering significant weight loss and remission of obesity-related diseases. However, SG is associated with a high risk of gastroesophageal reflux disease (GERD). To mitigate this issue, a modified procedure combining SG with Nissen fundoplication (Nissen-sleeve gastractomy [NSG]) has been developed.

The primary aim of this study was to assess the effectiveness of NSG in GERD remission. Secondary objectives included the evaluation of short-term weight loss and the resolution of obesity-related diseases.

We conducted s prospective analysis of 34 patients who underwent NSG between September 2023 and August 2024 at a single center in Poland. Inclusion criteria comprised age over 18 years, eligibility for metabolic and bariatric surgery, and GERD symptoms. Data on GERD severity and weight loss outcomes were collected before and after the surgery.

Mean (SD) preoperative body mass index was 40.3 (4.4) kg/m². GERD symptom severity decreased from a median score of 8 to 1 (P <⁠0.001), with 97.1% of the patients achieving GERD remission. Mean (SD) percentage of total weight loss was 23% (6.3%) at 6 months and 30.3% (6.7%) at 12 months postoperatively. Type 2 diabetes remission was observed in 28.6% of the patients, and hypertension remission, in 58.3%. No postoperative complications were reported.

NSG is a safe and effective procedure that leads to GERD remission, while achieving short-term satisfactory weight loss and mitigating obesity-related diseases.