A Randomized Controlled Trial of Acid and Bile Reflux Esophagitis Prevention by Modified Fundoplication of the Excluded Stomach in One-Anastomosis Gastric Bypass: 1-Year Results of the FundoRing Trial

Ospanov, Oral; Yeleuov, Galymzhan; Buchwald, J. N.; Zharov, N.; Yelembayev, Bakhtiyar; Sultanov, Kassymkhan

doi:10.1007/s11695-023-06618-y

Cited by 3 publications

(8 citation statements)

References 31 publications

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“…Following our publication, it is known that the FundoRing method differs significantly from OAGB without fundoplication [ 7 ]. This publication proves that FundoRingOAGB is better than OAGB in terms of antireflux and bariatric results.…”

Section: Discussionmentioning

confidence: 99%

“…In the FundoRingOAGB group ( Figure 2 C), the execution of various steps differed from NissenOAGB [ 7 , 11 ]: The gastrosplenic ligament was always divided to ensure good mobilization of the gastric fundus. The anterior and posterior parts of the mobilized fundus were joined at 2–3 o’clock.…”

Section: Methodsmentioning

confidence: 99%

“…Currently, one-anastomosis gastric bypass (OAGB) is a common, simple, and effective bariatric procedure, but excellent metabolic improvement following OAGB remains compromised by the risk of esophageal bile reflux [ 6 , 7 ]. Almost 20% of OAGB reoperations were conversions to RYGB due to bile reflux [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, we developed a modification of the Nissen procedure using the excluded stomach, which we called “FundoRing” [ 11 ]. Previously, we published the results of a randomized study using our method FundoRingOAGB (f-OAGB) vs. standard OAGB (s-OAGB) with 24 h pH impedance monitoring data [ 7 ]. It has been proven that using FundoRingOAGB to treat obese patients reduces acid reflux esophagitis, significantly more effectively than standard OAGB without fundoplication.…”

Section: Introductionmentioning

confidence: 99%

“…The special GERD-HRQL questionnaire was not used. We described cases of bile reflux after OAGB without fundoplication that occurred at night when, during sleep, bile entered the trachea, causing episodes of suffocation and fear [ 7 ]. Unfortunately, 24 h pH impedance monitoring, unlike GERD-HRQL, does not give data on bile reflux.…”

Section: Introductionmentioning

confidence: 99%

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A Three-Arm Randomized Controlled Trial of Primary One-Anastomosis Gastric Bypass: With FundoRing or Nissen Fundoplications vs. without Fundoplication for the Treatment of Obesity and Gastroesophageal Reflux Disease

Ospanov,

Zharov,

Yelembayev

et al. 2024

Medicina

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Background and Objectives: Obesity and gastroesophageal reflux disease (GERD) are steadily increasing world weight and antireflux surgery must be performed simultaneously with bariatric surgery in obese patients. The purpose of this study is to compare bariatric and antireflux results after OAGB with different methods of fundoplication using the excluded stomach and without fundoplication. Materials and methods: This open-label, randomized, parallel three-arm trial was conducted from March 2019 and December 2021. All patients underwent laparoscopic one-anastomosis gastric bypass and suture cruroplasty, and then had a follow-up at 24 months. Group 1 of patients had fundoplication FundoRing using the excluded stomach (FundoRingOAGB); Group 2, with Nissen fundoplication using the excluded stomach (NissenOAGB); and Group 3, without fundoplication (OAGB). We studied changes in BMI, GERD symptoms (GERD-HRQL), and the VISICK score. Results: Of 219 participants screened, 150 were randomly allocated to 3 groups: FundoRingOAGB group (n = 50), NissenOAGB group (n = 50), and OAGB group (n = 50). At post-treatment month 24, BMI changes were as follows: from 40.7 ± 5.9 (31–53) to 24.3 ± 2.8 (19–29) kg/m2 in FundoRingOAGB group; from 39.9 ± 5.3 (32–54) to 26.3 ± 2.9 (23–32) kg/m2 in Nissen group; and from 40.9 ± 6.2 (32–56) to 28.5 ± 3.9 (25–34) kg/m2 in OAGB group. The mean pre-operative GERD-HRQL heartburn score improved post-op in FundoRingOAGB group from 20.6 ± 2.24 (19.96, 21.23) to 0.44 ± 0.73 (0.23, 0,64); in NissenOAGB group from 21.34 ± 2.43 (20.64, 22.03) to 1.14 ± 1.4 (0.74, 1.53); and in OAGB group 20.5 ± 2.17 (19.9, 21.25) to 2.12 ± 1.36 (1.73, 2.5). GERD-HRQL total scores were from pre-op 25.2 ± 2.7 (24.4, 25.9) to 4.34 ± 1.3 (3.96, 4.7) post-op in FundoRingOAGB group; 24.8 ± 2.93 (24, 25.67) pre-op to 5.42 ± 1.7 (4.9, 5.9) in the NissenOAGB group; and from 21.46 ± 2.7 (20.7, 22.2) to 7.44 ± 2.7 (6.6, 8.2) in the OAGB group. The mean VISICK score improved from 3.64 ± 0.94 (3.7, 3.9) to 1.48 ± 1.26 (1.12, 1.84) in FundoRingOAGB, from 3.42 ± 0.97 (3.1, 3,7) to 2.5 ± 1.46 (2.06, 2.9) in NissenOAGB group and from 3.38 ± 0.88 (3.1, 3,69) to 2.96 ± 1.19 (2.62, 3.2) in OAGB group. Conclusions: Antireflux and bariatric results of FundoRingOAGB are better than using the NissenOAGB method and significantly better than OAGB without the use of fundoplication.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Three-Arm Randomized Controlled Trial of Primary One-Anastomosis Gastric Bypass: With FundoRing or Nissen Fundoplications vs. without Fundoplication for the Treatment of Obesity and Gastroesophageal Reflux Disease

Ospanov,

Zharov,

Yelembayev

et al. 2024

Medicina

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Revision/Conversion Surgeries After One Anastomosis Gastric Bypass—An Experts’ Modified Delphi Consensus

Kermansaravi,

Chiappetta,

Parmar

et al. 2024

OBES SURG

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Bile reflux after laparoscopic mini/one anastomosis gastric bypass: the problem and prevention

Vinnik,

Chaykin,

Chaykin

et al. 2024

Russian Medicine

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Laparoscopic mini-gastric bypass (LMGB) is currently one of the three most common bariatric surgical operations. One of the reasons for reoperations after LMGB is pathological bile reflux, which, in addition to a noticeable decrease in the quality of life of patients, poses a potential threat to the development of neoplastic processes in the stomach and esophagus. The purpose of the study was to systematize and analyze modern literature information on terminology, diagnosis and frequency of detection, pathophysiological significance and methods of preventing bile reflux after LMGB. An analysis of Russian and English full-text literature sources on the problem of bile reflux after LMGB in the bibliographic databases of the Russian Science Citation Index, PubMed, Google Scholar, ScienceDirect was performed. The frequency of diagnosing bile reflux after LMGB varies from 2 to 57.9% depending on the instrumental diagnostic methods used: flexible endoscopy, 24-hour pH impedance measurements, spectrophotometry of bilirubin in refluxate, hepatobiliary scintigraphy. The pathogenetic effect of the contents of the small intestine on the mucous membrane of the stomach and esophagus after LMGB is mainly realized due to the direct cytotoxic and receptor-mediated effects of bile acids. The safety of the main stages of LMGB (creation of a gastric pouch and formation of a single anastomosis) is currently being reviewed from the standpoint of minimizing the risk of developing bile reflux. In addition, new techniques have been proposed to reduce the likelihood of intestinal contents entering the stomach and esophagus, but their effectiveness remains controversial.

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A Randomized Controlled Trial of Acid and Bile Reflux Esophagitis Prevention by Modified Fundoplication of the Excluded Stomach in One-Anastomosis Gastric Bypass: 1-Year Results of the FundoRing Trial

Cited by 3 publications

References 31 publications

A Three-Arm Randomized Controlled Trial of Primary One-Anastomosis Gastric Bypass: With FundoRing or Nissen Fundoplications vs. without Fundoplication for the Treatment of Obesity and Gastroesophageal Reflux Disease

A Three-Arm Randomized Controlled Trial of Primary One-Anastomosis Gastric Bypass: With FundoRing or Nissen Fundoplications vs. without Fundoplication for the Treatment of Obesity and Gastroesophageal Reflux Disease

Revision/Conversion Surgeries After One Anastomosis Gastric Bypass—An Experts’ Modified Delphi Consensus

Bile reflux after laparoscopic mini/one anastomosis gastric bypass: the problem and prevention

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