Sleeve Gastrectomy with tailored 360° fundoplication according to Rossetti in patients affected by obesity and gastro-esophageal reflux: a prospective observational study

Abstract Background Laparoscopic Sleeve Gastrectomy (LSG) is the most performed bariatric procedure. Recent studies demonstrated the correlation between LSG and Gastro Esophageal Reflux Disease (GERD). Objectives The aim of this study is to evaluate the effectiveness of LSG + Rossetti anti-reflux fundoplication in patients affected by morbid obesity and GERD. Settings High-volume Bariatric Center, Public Hospital, Italy. Materials and Methods This is a prospective observational cohort study. 58 patients affected by obesity and GERD were enrolled and underwent surgery. All the patients had a 12 month follow up. 35 patients had gastroscopy pre-operative and at 12th month. Results One year after surgery, patients had a consistent decrease in Body Mass Index (BMI), from 41.9 ± 4.6 kg/m2 to 28.2 ± 3.7 kg/m2. GERD improved in 97.1% of patients. Comorbidities, such as hypertension, Type 2 diabetes (T2D), respiratory disfunction and arthropaties improved as well. The Visual Analogue Score (VAS) score regarding the global state of health increased significantly from 58.1 ± 17.1% before surgery to 98.8 ± 4.1% one year after. 2 patients had fundoplication perforation and needed reparative surgery (3.5%). One patient had anemia that needed blood transfusion (1.7%). Complications were reduced with a learning curve. Conclusions LSG + Rossetti fundoplication was shown to be a safe and effective intervention. It could be considered an option in obese patients affected by GERD. A longer follow up is needed to establish the long-term outcome.