title: Randomized controlled trial comparing laparoscopic greater curvature plication versus laparoscopic sleeve gastrectomy.
abstract: Laparoscopic greater curvature plication (LGCP) is a new restrictive bariatric procedure, which has a similar restrictive mechanism like laparoscopic sleeve gastrectomy (LSG) without potential risk of leak. Aim of the study was to compare 2-year outcomes of LSG and LGCP.
  
  
  
  Multicenter prospective randomized trial was started in 2010. A total of 54 patients with morbid obesity were allocated either to LGCP group (n = 25) or LSG group (n = 27). Main exclusion criteria were: ASA > III, age > 75 and BMI > 65 kg/m(2). There were 40 women and 12 men, and the mean age was 42.6 ± 6.8 years (range 35-62). Data on the operation time, complications, hospital stay, body mass index loss, percentage of excess weight loss (%EWL), loss of appetite and improvement in comorbidities were collected during the follow-up examinations.
  
  
  
  All procedures were completed laparoscopically. The mean operative time was 92.0 ± 15 min for LSG and 73 ± 19 min for LGCP (p > 0.05). The mean hospital stay was 4.0 ± 1.9 days in the LSG group and 3.8 ± 1.7 days in LGCP group (p > 0.05). One year after surgery, the mean %EWL was 59.5 ± 15.4 % in LSG group and 45.8 ± 17 % in LGCP group (p > 0.05). After 2 years, mean %EWL was 78.9 ± 20 % in the LSG group and 42.4 ± 18 % in the LGCP group (p < 0.01). After 3 years, mean %EWL was 72.8 ± 22 in the LSG group and only 20.5 ± 23.9 in the LGCP group (p < 0.01). Loss of feeling of hunger after 2 years was 25 % in LGCP group and 76.9 % in the LSG group (p < 0.05). The comorbidities including diabetes, sleep apnea and hypertension were markedly improved in the both groups after surgery.
  
  
  
  The short-term outcomes demonstrated equal effectiveness of the both procedures, but 2-year follow-up showed that LGCP is worse than LSG as a restrictive procedure for weight loss.
authors.affiliation: Department of Surgery, Odessa National Medical University, Odessa, Ukraine. uamelt@gmail.com.|Ukrainian Association for Minimally Invasive, Endoscopic and Laser Technologies, Odessa, Ukraine. uamelt@gmail.com.|Department of Surgery, Odessa State Hospital, Zabolotnogo str. 26/32, Odessa, 65025, Ukraine. uamelt@gmail.com.
authors.forename: V V
authors.initials: VV
authors.lastname: Grubnik
authors.affiliation: Department of Endosurgery, The Astana Medical University, Astana, Kazakhstan.|Kazakh Association for Endoscopic Surgery, Astana, Kazakhstan.
authors.forename: O B
authors.initials: OB
authors.lastname: Ospanov
authors.affiliation: Department of Endosurgery, The Astana Medical University, Astana, Kazakhstan.
authors.forename: K A
authors.initials: KA
authors.lastname: Namaeva
authors.affiliation: Department of Surgery, Odessa National Medical University, Odessa, Ukraine.
authors.forename: O V
authors.initials: OV
authors.lastname: Medvedev
authors.affiliation: Department of Surgery, Odessa National Medical University, Odessa, Ukraine.
authors.forename: M S
authors.initials: MS
authors.lastname: Kresyun
mesh_terms: D000328:Adult; D001066:Appetite / Q000502:physiology; D015897:Comorbidity; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D061646:Operative Time; D011183:Postoperative Complications; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Laparoscopic greater curvature plication; Laparoscopic sleeve gastrectomy; Morbid obesity