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Cardiopexy at the Time of Sleeve Gastrectomy as a Preventive Measure for Reflux

Background: One of the most significant concerns after laparoscopic sleeve gastrectomy (LSG) is the new-onset or worsening of gastroesophageal reflux disease (GERD). Some patients with LSG undergo a conversion to Roux-en-Y gastric bypass (RYGB) because of severe GERD. Cardiopexy at the time of LSG may help prevent GERD. This study aims to examine the safety and effectiveness of cardiopexy at the time of LSG.

Methods: A retrospective chart review was performed on 161 consecutive patients who underwent LSG between May 1, 2017 and April 30, 2018. Of these, 79 underwent cardiopexy at the time of LSG. Weight, comorbidities, and complications were recorded at 6 months after LSG.

Results: Baseline characteristics were similar between the cardiopexy and noncardiopexy groups of patients. In the cardiopexy group, 8 (10.1%) patients reported having GERD at the time of LSG, whereas 12 (14.6%) patients did in the noncardiopexy group. At 6 months after the procedure, 5 (8.9%) patients in the cardiopexy group reported symptoms of GERD, whereas 14 (17.7%) patients did in the noncardiopexy group (P=0.15). One (1.3%) patient in the cardiopexy group and 2 (2.4%) patients in the noncardiopexy group were converted to an RYGB because of severe reflux (P=0.58). The percentage of excess body mass index loss and the percentage of total weight loss were similar between the 2 groups.

Conclusion: Cardiopexy was not associated with a reduced rate of symptomatic GERD and conversion to RYGB after 6 months.

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