LAPAROSCOPIC PARTIAL FUNDOPLICATION WITH MINIMAL DISSECTION TO CONTROL GASTROESOPHAGEAL DISEASE SYMPTOMS?

SAMI S. AHMAD, SUFIAN AHMAD, V. PYLIAVETS

Obesity center, Gastriccenter, Stuttgart, GERMANY,

Jordan Obesity center/Jordan Hospital Jordan Hospital, Amman, JORDAN

Background: Gastroesophageal reflux disease is a common one and the surgical procedures performed to control it have got the same principles. To determine the effect of laparoscopic partial fundoplication with minimal dissection we observed our results between one and 9 years postoperatively.

Methods: Between Dec. 1999 and Aug. 2009, 960 patients with confirmed gastroesophageal reflux disease were treated with partial fundoplication without dissection of the short gastric vessels. Available for the follow up were 880 patients (44%) female and 56% male. They all underwent a detailed pre-op. diagnostic including clinical history and upper GI-endoscopy. A questionnaire was filled for every patient, preoperatively, two weeks postoperatively. 4weeks, 3months, 6months, and then annually up to 9 years post-operatively recording remaining symptoms, or new symptoms related to the gastrooesophageal reflux disease or to the antireflux procedure, determined by either yes/no questioning or a 0-to-10 visual analog scale. and recurrence rate as well as assessment of postoperative quality of life , assessed on visual analog scale von 0-10,

Results: typical and atypical reflux disease symptoms disappeared in 95%. In 3% of the cases they felt improvement. 2% of the patient remained to have the same symptoms as preoperatively determined by either yes/no questioning or a 0-to-10 visual analog scale. The incidence of increased flatus production, epigastric bloating, and postop. Dysphagea was increased within the first 6 weeks and improved after that. The quality of life has improved,.

Conclusions: Partial wrap fundoplication in the measured clinical outcomes at 1-9years follow up seem to be safe and controls typical and atypical reflux disease symptoms .

SLEEVE GASTRECTOMY TO TREAT MORBID OBESITY AND ITS

CO-MORBIDITY

SAMI S. AHMAD, SUFIAN AHMAD, V. PYLIAVETS

Obesity center, Gastriccenter, Stuttgart, GERMANY,

Jordan Obesity center/Jordan Hospital Jordan Hospital, Amman, JORDAN

Background: Morbid obesity (MO) is a world wide problem, and its' incidence is increasing at an alarming rate. Surgical therapy has been shown to result in significant and sustainable weight loss in comparison to medical management of the disease. The positive effect on the co-morbidities, like diabetes mellitus type 2, hypertension, hyperlipidaemia and joint pain was observed in many studies.

Objectives: To analyze prospectively, the outcomes of sleeve gastrectomy to treat morbidly obese patients in our center during the period 2001-2010.

Method: 450 morbidly obese patients underwent Laparoscopic sleeve gastrectomy (SG) for weight reduction, 430 were available for follow up, 25% males, 75% females, mean age 32.4 + 9.6 Years, mean weight 122. kg, mean BMI 44 kg/m2. We investigated body mass index (BMI) changes, intra- and postoperative complications, patient satisfaction, changes of the co-morbidity related to obesity. Follow up visits monthly in the1st year, 3 months visits in the 2^nd year, then once yearly at least. post-operative complications and patients satisfactions were assessed using Moorhead –Ardelt Quality of life questionnaire (self esteem and activity level) have been considered.

Result:. Mortality rate was (0.2%) in the operative period, . Mean excess weight loss ( EWL)% at 3 months 30% , 60% at 6months 73 % at 1year, 76% at 18 months,80 % at 2years,78 %at 3 years,75% at 4 years,73% in 5^th year co-morbidities (Diabetes mellitus, hypertension, Joint pain, hyperlipidaemia, shortness of breath ) disappeared or improved in more than 70 % of patients. Quality of life score improved in the majority of patients.

Conclusions: Sleeve gastrectomy is an efficient procedure in the hand of the expertise to reduce overweight, decrease co-morbidity and improve quality of life.

Date: 2014-12-28; view: 888