One-Anastomosis Gastric Bypass and Hiatal Hernia: Nissen Fundoplication with the Excluded Stomach to Decrease the Risk of Postoperative Gastroesophageal Reflux
Introduction: The realization of an antireflux valve according to the Nissen technique during the operation of one-anastomosis gastric bypass (OAGB) may theoretically decrease the incidence of postoperative reflux in patients with hiatal hernia (HH). Material and Methods: In this retrospective study...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-10-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/21/6441 |
| _version_ | 1797467745148731392 |
|---|---|
| author | Antoine Soprani Hortense Boullenois Viola Zulian Anamaria Nedelcu Sergio Carandina |
| author_facet | Antoine Soprani Hortense Boullenois Viola Zulian Anamaria Nedelcu Sergio Carandina |
| author_sort | Antoine Soprani |
| collection | DOAJ |
| description | Introduction: The realization of an antireflux valve according to the Nissen technique during the operation of one-anastomosis gastric bypass (OAGB) may theoretically decrease the incidence of postoperative reflux in patients with hiatal hernia (HH). Material and Methods: In this retrospective study, we included all patients operated on between January 2015 and January 2019 for an OAGB associated with the creation of an antireflux Nissen valve (360-degree wrap). The patients included had type II or type III HH that had been diagnosed preoperatively or discovered intraoperatively. Results: Twenty-two patients were operated on during the period considered. The mean preoperative BMI was 40 ± 14 kg/m<sup>2</sup>. Five patients (22.7%) had a history of bariatric surgery. Typical symptoms of gastroesophageal reflux disease (GERD) were preoperatively present in four patients (18%), and HH was revealed preoperatively only in four patients; for all the other patients, the diagnosis of HH was made intraoperatively. The rate of early and/or late postoperative complications was 0%. The mean duration of follow-up was 23 ± 15 months. No dysphagia was reported during follow-up. Three patients presented with symptomatic GERD postoperatively, including one de novo. Mean BMI at the end of follow-up was 24 ± 3 kg/m<sup>2</sup>, and the % of total weight loss was 108 ± 30%. Conclusions: OAGB with a Nissen antireflux valve seems to be a safe and effective surgical technique and it could be an extra arrow in the surgeon’s quiver in the presence of HH in a patient scheduled for OAGB. |
| first_indexed | 2024-03-09T18:58:05Z |
| format | Article |
| id | doaj.art-d84e7628bc5342caabff1a59b85c8ed3 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T18:58:05Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-d84e7628bc5342caabff1a59b85c8ed32023-11-24T05:17:43ZengMDPI AGJournal of Clinical Medicine2077-03832022-10-011121644110.3390/jcm11216441One-Anastomosis Gastric Bypass and Hiatal Hernia: Nissen Fundoplication with the Excluded Stomach to Decrease the Risk of Postoperative Gastroesophageal RefluxAntoine Soprani0Hortense Boullenois1Viola Zulian2Anamaria Nedelcu3Sergio Carandina4Department of Digestive and Bariatric Surgery, Geoffroy-Saint Hilaire Hospital, Générale de Santé (GDS), 75005 Paris, FranceDepartment of Digestive and Bariatric Surgery, Geoffroy-Saint Hilaire Hospital, Générale de Santé (GDS), 75005 Paris, FranceELSAN, Saint Michel Hospital, Centre Chirurgical de l’Obésité (CCO), 83100 Toulon, FranceELSAN, Saint Michel Hospital, Centre Chirurgical de l’Obésité (CCO), 83100 Toulon, FranceELSAN, Saint Michel Hospital, Centre Chirurgical de l’Obésité (CCO), 83100 Toulon, FranceIntroduction: The realization of an antireflux valve according to the Nissen technique during the operation of one-anastomosis gastric bypass (OAGB) may theoretically decrease the incidence of postoperative reflux in patients with hiatal hernia (HH). Material and Methods: In this retrospective study, we included all patients operated on between January 2015 and January 2019 for an OAGB associated with the creation of an antireflux Nissen valve (360-degree wrap). The patients included had type II or type III HH that had been diagnosed preoperatively or discovered intraoperatively. Results: Twenty-two patients were operated on during the period considered. The mean preoperative BMI was 40 ± 14 kg/m<sup>2</sup>. Five patients (22.7%) had a history of bariatric surgery. Typical symptoms of gastroesophageal reflux disease (GERD) were preoperatively present in four patients (18%), and HH was revealed preoperatively only in four patients; for all the other patients, the diagnosis of HH was made intraoperatively. The rate of early and/or late postoperative complications was 0%. The mean duration of follow-up was 23 ± 15 months. No dysphagia was reported during follow-up. Three patients presented with symptomatic GERD postoperatively, including one de novo. Mean BMI at the end of follow-up was 24 ± 3 kg/m<sup>2</sup>, and the % of total weight loss was 108 ± 30%. Conclusions: OAGB with a Nissen antireflux valve seems to be a safe and effective surgical technique and it could be an extra arrow in the surgeon’s quiver in the presence of HH in a patient scheduled for OAGB.https://www.mdpi.com/2077-0383/11/21/6441one-anastomosis gastric bypasshiatal herniaobesityNissen fundoplication |
| spellingShingle | Antoine Soprani Hortense Boullenois Viola Zulian Anamaria Nedelcu Sergio Carandina One-Anastomosis Gastric Bypass and Hiatal Hernia: Nissen Fundoplication with the Excluded Stomach to Decrease the Risk of Postoperative Gastroesophageal Reflux Journal of Clinical Medicine one-anastomosis gastric bypass hiatal hernia obesity Nissen fundoplication |
| title | One-Anastomosis Gastric Bypass and Hiatal Hernia: Nissen Fundoplication with the Excluded Stomach to Decrease the Risk of Postoperative Gastroesophageal Reflux |
| title_full | One-Anastomosis Gastric Bypass and Hiatal Hernia: Nissen Fundoplication with the Excluded Stomach to Decrease the Risk of Postoperative Gastroesophageal Reflux |
| title_fullStr | One-Anastomosis Gastric Bypass and Hiatal Hernia: Nissen Fundoplication with the Excluded Stomach to Decrease the Risk of Postoperative Gastroesophageal Reflux |
| title_full_unstemmed | One-Anastomosis Gastric Bypass and Hiatal Hernia: Nissen Fundoplication with the Excluded Stomach to Decrease the Risk of Postoperative Gastroesophageal Reflux |
| title_short | One-Anastomosis Gastric Bypass and Hiatal Hernia: Nissen Fundoplication with the Excluded Stomach to Decrease the Risk of Postoperative Gastroesophageal Reflux |
| title_sort | one anastomosis gastric bypass and hiatal hernia nissen fundoplication with the excluded stomach to decrease the risk of postoperative gastroesophageal reflux |
| topic | one-anastomosis gastric bypass hiatal hernia obesity Nissen fundoplication |
| url | https://www.mdpi.com/2077-0383/11/21/6441 |
| work_keys_str_mv | AT antoinesoprani oneanastomosisgastricbypassandhiatalhernianissenfundoplicationwiththeexcludedstomachtodecreasetheriskofpostoperativegastroesophagealreflux AT hortenseboullenois oneanastomosisgastricbypassandhiatalhernianissenfundoplicationwiththeexcludedstomachtodecreasetheriskofpostoperativegastroesophagealreflux AT violazulian oneanastomosisgastricbypassandhiatalhernianissenfundoplicationwiththeexcludedstomachtodecreasetheriskofpostoperativegastroesophagealreflux AT anamarianedelcu oneanastomosisgastricbypassandhiatalhernianissenfundoplicationwiththeexcludedstomachtodecreasetheriskofpostoperativegastroesophagealreflux AT sergiocarandina oneanastomosisgastricbypassandhiatalhernianissenfundoplicationwiththeexcludedstomachtodecreasetheriskofpostoperativegastroesophagealreflux |