Laparoscopic Greater Curvature Plication versus Laparoscopic Sleeve Gastrectomy, a Long- Term Prospective Randomized Comparison

Abstract

The objective of this prospective randomized study was to compare outcome and complications between LGCP and LSG.Patients and methods: This study was performed on 40 patients randomly categorized into 2 groups through a computer randomization program. Group P included 20 patients who underwent LGCP. This group was compared to 20 patients who underwent LSG. (Group S). The mean length of follow up was 65.1±15.7 and 63.9±15.6 months (P = 0.810).Results: Mean operative time was 117±17.9 in group P and 111±17.3 minutes in group S (P = 0.31). Mean hospitalization time was 4.85±1.81 and 3.55±1.32 days (p = 0.013). Mean time for return to normal activity was19.2±3.69 and 18.9±4.29 days (p = 0. 0.81). There was no surgery related mortality. One at each group (5 %) needed conversion to open surgery. Eleven patients (55.0 %) in Group P and 5 patients (25.0 %) in the Group S had minor complications (p 0.02). One patient (5 %) in Group P had port-site bleeding. In Group S gastric leak occurred in 1 patient. She was treated by re-stapling the leak site and placing an abdominal drain. One patient in the group S required readmission during the first 30 days after surgery, for subphrenic abscess that was treated conservatively. (p: 0.41). During late follow-up, there were 3 surgical interventions, laparoscopic cholecystectomy was done for cholelithiasis in one patient from each group and hernioplasty for umbilical port hernia was done to the other Group P patient. Loss of feeling of hunger at 6, 12 and 60 months postoperatively showed significant differences. The patients in Group S had a greater BMI loss and PEWL after surgery compared with those in Group P. No weight loss failure was observed in any patient of the two groups. After 12 months follow-up, the major comorbidities improved markedly in both groups, and there was no significant difference between the two groups. The mean patient satisfaction score for was 8.75±1.35 versus 9.04±1 (p = 0.51). Conclusion:LGCP is feasible and safe when applied to morbidly obese patients, but compared with LSG it is inferior to LSG as a restrictive procedure for weight loss, despite its less cost and simpler procedure.