A case-control comparative study between Toupet-Sleeve and conventional sleeve gastrectomy in patients with preoperative gastroesophageal reflux

Hauters, P.; Vyve, E. Van; I, Stefănescu; Gielen, Charles-Edouard; Nachtergaele, Sylvie; Mahaudens, Manon

doi:10.1080/00015458.2021.1922189

Cited by 6 publications

(3 citation statements)

References 37 publications

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“…Hauters and colleagues achieved 89% remission in GERD in 19 patients in whom they applied the T-sleeve procedure; however, these patients could not achieve sufficient success in terms of weight loss compared with the LSG group with an EWL rate of 61%. Furthermore, one of their patients developed dysphagia and gas bloating due to wrap dilation during the follow-up 27. In our study, we have not seen any dysphagia or symptomatic gas bloating in the T-sleeve group.…”

Section: Discussioncontrasting

confidence: 38%

“…Furthermore, one of their patients developed dysphagia gas bloating due to wrap dilation during the follow-up. 27 In our study, we have not seen any dysphagia or symptomatic gas bloating in the T-sleeve group. In the studies we have published before, we have reported gas bloating syndrome in 40% of the patients in the short term and > 50% of the patients in the long term after Nissen fundoplication.…”

Section: Discussionmentioning

confidence: 38%

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Combined Partial Toupet Fundoplication With Laparoscopic Sleeve Gastrectomy for Patients With Morbid Obesity and Symptomatic GERD: Preliminary Results of the T-sleeve Technique

Türkçapar¹,

Şen

2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Aim: The aim of this study to reveal preliminary results of our Toupet-sleeve technique in morbid obese patients with symptomatic gastroesophageal reflux disease (GERD) and compare their outcomes with laparoscopic sleeve gastrectomy (LSG) patients’ outcomes. Methods: The study included 103 patients who underwent primary LSG between March 2018 and October 2020 and 18 patients who underwent partial T-sleeve. Patients were stratified into 2 groups according to the surgical technique. All of the patients had preoperative symptomatic GERD. Patients were reevaluated with regard to GERD symptoms and weight loss in the postoperative period. Two groups’ data were compared. Results: The mean age of the patients was 39.2±10.2 years (63% female), and the mean body mass index was 43.2±6.4 kg/m2. The median operative time was 93 minutes (75 to 110 min) in group A (primary LSG) and 110 minutes (90 to 120 min) in group B (partial T-sleeve). The mean body mass index decreased to 28±4.5 kg/m2 in group A and 25.8±3.5 kg/m2 in group B at 12 months after the surgery. At the 12th month, the patients were reevaluated for GERD symptoms. Reflux symptoms were found to be resolved in 62% of the patients (n=64) in group A, while 32% of the patients (n=39) had persistent GERD symptoms. In group B, all of the patients had discontinued proton pump inhibitors postoperatively, and GERD symptoms were completely resolved in 94% of these patients (n=17). Conclusions: The present study showed that T-sleeve provides a very good weight loss and reflux control in patients with symptomatic GERD with morbid obesity in the short-term period. This technique can be proposed in some cases as a primary treatment modality. High numbers of patients and longer follow-up are needed.

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Section: Discussioncontrasting

confidence: 38%

Section: Discussionmentioning

confidence: 38%

Combined Partial Toupet Fundoplication With Laparoscopic Sleeve Gastrectomy for Patients With Morbid Obesity and Symptomatic GERD: Preliminary Results of the T-sleeve Technique

Türkçapar¹,

Şen

2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…Several techniques of fundoplication-like have been recently introduced to control the GERD issues after LSG: Nissen Sleeve (N-sleeve) [ 52 ], anterior (Dor) fundoplication and sleeve (D-Sleeve) [ 53 ], Rossetti-Sleeve (R-sleeve) [ 54 ], and Toupet Sleeve [ 55 ]. None of them are acting in the classical meaning of AR surgery as the fundus wrap is small and stretched, almost excluded from the rest of the stomach, while offering a very limited room to work as an AR pneumo-valve [ 47 ].…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of the phreno-esophageal ligament (R-PEL) prevents the intrathoracic migration (ITM) after concomitant sleeve gastrectomy and hiatal hernia repair

Hutopilă

Ciocoiu²,

Paunescu³

et al. 2023

Surg Endosc

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Background Laparoscopic Sleeve Gastrectomy (LSG) is the most attractive bariatric procedure, but the postoperative intrathoracic gastric migration (ITM) and “de novo” GERD are major concerns. The main objective of our study was to evaluate the efficiency of the concomitant HHR with or without partial reconstruction of phreno-esophageal ligament (R-PEL) to prevent ITM after LSG. The secondary objectives focused on procedure’s metabolic and GERD-related outcomes. Patients and method Consecutive patients who underwent primary LSG and concomitant HHR were included in a single-center prospective study. According to the HHR surgical technique, two groups were analyzed and compared: Group A included patients receiving crura approximation only and Group B patients with R-PEL. The patients’ evolution of co-morbidities, GERD symptoms, radiologic, and endoscopic details were prospectively analyzed. Results Two hundred seventy-three patients undergoing concurrent HHR and LSG were included in the study (Group A and B, 146 and 127 patients) The mean age and BMI were 42.6 ± 11.3 and 43.4 ± 6.8 kg/m 2 . The 12-month postoperative ITM was radiologically found in more than half of the patients in Group A, while in group B, the GEJ’s position appeared normal in 91.3% of the patients, meaning that R-PEL reduced 7 times the rate of ITM. The percentage of no-improvement and “de novo” severe esophagitis (Los Angeles C) was 4 times higher in group A 3.4% vs. 0.8% with statistical significance, and correlated to ITM. The GERD symptoms were less frequent in Group B vs Group A, 21.3% vs 37%, with statistical significance. No Barrett’s esophagus and no complication were recorded in any of the patients. Conclusion Concurrent LSG and HHR by crura approximation only has a very high rate of ITM in the first postoperative year (over 50%). R-PEL is an innovative technique which proved to be very efficient in preventing the ITM after HHR.

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Gastroesophageal Reflux Disease and Weight Loss After Fundoplication Sleeve Gastrectomy: a Systematic Review and Meta-analysis

Mu,

Saber

2023

OBES SURG

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A case-control comparative study between Toupet-Sleeve and conventional sleeve gastrectomy in patients with preoperative gastroesophageal reflux

Cited by 6 publications

References 37 publications

Combined Partial Toupet Fundoplication With Laparoscopic Sleeve Gastrectomy for Patients With Morbid Obesity and Symptomatic GERD: Preliminary Results of the T-sleeve Technique

Combined Partial Toupet Fundoplication With Laparoscopic Sleeve Gastrectomy for Patients With Morbid Obesity and Symptomatic GERD: Preliminary Results of the T-sleeve Technique

Reconstruction of the phreno-esophageal ligament (R-PEL) prevents the intrathoracic migration (ITM) after concomitant sleeve gastrectomy and hiatal hernia repair

Gastroesophageal Reflux Disease and Weight Loss After Fundoplication Sleeve Gastrectomy: a Systematic Review and Meta-analysis

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