Cruroplasty added to laparoscopic sleeve gastrectomy; does it decrease postoperative incidence of de-novo acid reflux?: A randomised controlled trial

Abstract

Background: Laparoscopic sleeve gastrectomy(LSG) is the most popular bariatric surgery worldwide. Postoperative de-novo acid reflux is one of the major common complications of the procedure. Different additive anti-reflux surgical techniques have been tried to decrease the complication although no favorable outcome is obtained. This study was conducted to evaluate effects of concurrent cruroplasty during LSG on postoperative denovo acid reflux incidence rate. Methods: In current participant-blinded randomised controlled trial total of 80 subjects who were candidate for LSG were enrolled from the September 2018 to the December 2019. Following matching patients by gender and age, simple randomization method was held to allocate participants to LSG alone and LSG + cruroplasty groups with equal 40 members in each. Demographic data, length of hospital stay, and operation time was registered. Presence of acid reflux was looked by using gastroesophageal reflux disease-health related quality of life(GERDHRQL) questionnaire prior and 6 months after surgery in follow-up visit. Results: Finally 12/28 and 14/26 male/females with 38.5 +/- 10.7 and 39.7 +/- 8.2 years of age were recruited in LSG alone and LSG + cruroplasty, respectively.(p > 0.05) The length of operative time was significantly shorter in LSG alone(p < 0.01) although no obvious difference was existed in length of hospital stay between groups.(p = 0.7) Postoperative de-novo acid reflux also was not considerably lesser after cruroplasty compared with controls.(p = 0.1) The GERD-HRQL scores were not remarkable between subjects of study groups.(p > 0.05). Conclusion: Equipping LSG with concurrent cruroplasty to diminish postoperative de-novo gastroesophageal acid reflux is not effective and not recommended in absence of other indications.