OBJECTIVE

To evaluate an effectiveness of laparoscopic bariatric surgery — sleeve gastrectomy and gastric plication.

MATERIAL AND METHODS

In 2017, laparoscopic gastric plication in 47 obese patients and sleeve gastrectomy in 108 patients were performed at the Askerkhanov Medical Center and Loginov Moscow Clinical Scientific Center. Patients with morbid obesity (BMI ≥40 kg/m²) and obesity grade II (BMI ≥35.0 kg/m²) with one of such comorbidities as hypertension, diabetes mellitus type II, sleep apnea, degenerative joint disease, cholelithiasis underwent surgical treatment. The first group consisted of 35 patients who underwent laparoscopic gastric plication, the second group — 87 patients after laparoscopic sleeve gastrectomy. Overweight loss, quality of life, and course of comorbidities were evaluated before surgery, in 12 and 24 months after surgery. MOS SF-36 questionnaire was used to assess the quality of life.

RESULTS

Overweight loss after 24 months was 52.4±6.1% and 67.9±8.4% in the first and second groups, respectively (p=0.001). Quality of life after gastric plication is lower compared to sleeve gastrectomy. The greatest difference in favor of sleeve gastrectomy was obtained after 24 months regarding physical functioning (64.3±14.9 vs. 79.2±17.7; p=0.010) and emotional functioning (60.7±28.8 vs. 78.0±25.2; p=0.009). Regression of comorbidities after sleeve gastrectomy is more significant than after gastric plication.

CONCLUSION

Gastric plication is less effective than sleeve gastrectomy. However, postoperative morbidity requiring redo surgery is lower after gastric plication.