Background: Laparoscopic gastric greater curvature plication (LGGCP) is a novel bariatric procedure. Few studies have presented intermediate or long-term results. The aim of this prospective study was to investigate intermediate results and factors associated with failure to achieve satisfactory weight loss after LGGCP.
Methods: Between October 2011 and November 2013, 61 patients underwent LGGCP and were followed up to 36 months after operation. Demographics, comorbidities, complications, and percentage of excess body mass index loss (%EBMIL) were analyzed. Logistic regression analysis was used to determine independent risk factors for weight loss failure 3 years after LGGCP.
Results: Forty-eight women and 13 men with an average age of 47.7 ± 10.3 years and preoperative BMI of 46.3 ± 5.8 underwent LGGCP. Postoperative complications were observed in three patients (4.9%) and two of them (3.3%) underwent reoperations. Follow-up rate was 95%, 91.7, and 88.3% after 1, 2, and 3 years, respectively. Average %EBMIL after 1 year was 47.25 ± 21.6, 44.8 ± 25.9 after 2 years, and 41.9 ± 25.6 after 3 years. Gastroscopy 3 years after LGGCP demonstrated intact plication fold in 55% of cases. Preoperatively, GERD was present in 46% of patients. Prevalence of GERD 3 years after LGGCP was 34.6%. Remission rates of type 2 diabetes mellitus and hypertension were 27.8 and 38.3%, respectively. Higher postoperative hunger sensation was found to be an independent factor (OR 1.6, 95% 1.141-2.243; p = 0.002) associated with unsatisfactory weight loss after LGGCP.
Conclusions: Patients with LGGCP had postoperative complication rate 4.9% and achieved only modest weight loss after 3 years. Increased hunger was an independent risk factor associated with unsatisfactory weight loss after LGGCP. Long-term follow-up data are needed to define the role of LGGCP in the treatment of morbid obesity.
Keywords: Bariatric surgery; Gastric plication; Laparoscopic gastric greater curvature plication; Morbid obesity; Weight loss.