Quality of Life Outcomes After Fundoplication-Augmented One-Anastomosis Gastric Bypass: A Randomized Comparative...

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Surgical Innovation

Background:

• Gastroesophageal reflux disease (GERD) often persists after bariatric surgery, impacting patient quality of life.
• One-anastomosis gastric bypass (OAGB) is effective for weight loss but may not fully resolve GERD symptoms.

Purpose of the Study:

• To evaluate the efficacy of incorporating a modified fundoplication with OAGB for improved GERD symptom control.
• To assess the impact on health-related quality of life (HRQoL) in patients with obesity and GERD.

Main Methods:

• A prospective randomized comparative study involving 60 patients with obesity and GERD.
• Patients were divided into two groups: OAGB alone versus OAGB with modified fundoplication.
• Outcomes assessed included upper GI findings, manometry, GERD-HRQL scores, and PPI use over two years.

Main Results:

• The OAGB with fundoplication group showed significantly better symptom control (Visick score) and reduced PPI duration compared to OAGB alone.
• Significant improvements in GERD-HRQL scores were observed in the fundoplication group at six and 24 months.
• Endoscopic and manometric evaluations at 24 months confirmed intact wraps and restored LES function without GERD evidence.

Conclusions:

• Combined OAGB and modified fundoplication significantly enhance quality of life for obese GERD patients.
• This approach offers superior symptom management, reduced PPI dependence, and improved reflux control.
• Further validation with larger studies and pH impedance monitoring is recommended.