Initial Experience with the Surgical Management of Morbid Obesity Associated with Symptomatic Gastro-esophageal Reflux: A Comparison between Gastroplasty Alone and Gastroplasty with Anterior Fundoplication.
The optimal management of patients with morbid obesity and gastro-esophageal reflux disease (GERD) remains an unresolved issue. We have performed a vertical banded gastroplasty combined with an anterior fundoplication (VBG + AF) in 28 selected morbidly obese patients with moderate or severe heartburn. The patients who underwent VBG +/- AF are compared to patients who had similar heartburn symptoms and underwent gastroplasty alone during this period. In the VBG + AF group there were two treatment failures (7%). In the gastroplasty group there were 63 patients with 15 treatment failures (24%). These differences were independent of demographic and weight loss variables. These results suggest that VBG +/- AF may provide a superior option for the management of morbidly obese patients with GERD.
Chiasson
PM
Departments of Surgery and Medicine, Dalhousie University, Halifax, NS, B3H 2Y9, Canada.
Perey
BJ
Veldhuyzen Van Zanten SJ