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Updated: Mar 27, 2026
Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
EFFECTIVENESS OF LIGAMENTUM TERES CARDIOPEXY FOR GERD RESOLUTION AFTER SLEEVE GASTRECTOMY: A META-ANALYSIS AND
Pedro Bicudo Bregion1, Victor Kenzo Ivano2, Luca Maunsell Pereira1
1Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Estudante de Graduação, Campinas, SP, Brasil.
Background:
Gastroesophageal Reflux Disease (GERD) is the most common long-term complication after Sleeve Gastrectomy (SG). Ligamentum teres cardiopexy (LTC) has been proposed as a revisional alternative to treat GERD symptoms.
Objective:
To evaluate, through a systematic review and meta-analysis, the safety and effectiveness of LTC in the remission of GERD symptoms and in reducing the use of anti-reflux medications in patients who previously underwent SG.
Methods:
We conducted a systematic review and meta-analysis to evaluate LTC's safety and its impact on GERD after SG. We systematically searched PubMed, EMBASE, and Cochrane Central for studies assessing LTC in patients who underwent SG up to april 2025. The primary outcomes included remission of GERD symptoms and prevalence of GERD medications after surgery. Secondary outcomes were length of stay and adverse effects. Observational studies were included. A random-effects model analysis for GERD remission and prevalence of GERD medications were performed. Study weights were calculated using the inverse variance method, with statistical analyses conducted in R version 4.4.0.
Results:
Four studies including 193 patients were analyzed. Overall, remission of GERD symptoms among patients undergoing revisional LTC alone, the remission rate was 75.50% (95%CI 59.55-86.57; I²=41.4%). Additionally, 33.42% of patients (95%CI 19.74-50.60; I²=44.7%) needed to use GERD-related medication postoperatively.
Conclusion:
LTC shows potential as a surgical option for managing GERD after SG, particularly in revisional cases as an alternative to Roux-en-Y gastric bypass.
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