Ashraf A Bakr, Professor, Dr, Mohamed Y Selim, Professor, Dr. Faculty of Medicine, Cairo University
Introduction: Obesity in Egypt soared to a high 40%. Consequently, the rate of bariatric surgery increased fourfold, including laparoscopic greater curvature plication (LGCP). Illiteracy and poor patient compliance affect the outcome of surgical procedures, including bariatric procedures.
The aim of this study was to evaluate the impact of intensive patient education and strict postoperative care and monitoring on the outcome of LGCP.
Patients and Methods: This study included 53 patients, presenting with morbid obesity with Body Mass Index (BMI) < 40 kg/m². The study was conducted from June 2016 till February 2018. All patients were enrolled in a comprehensive program. The complements of the program included preoperative orientation about
- Obesity
- Nutrition (pre and postoperative)
- Weight loss surgery
- How to maintain weight loss after surgery
- Changes expected in co-morbidities
The patients then underwent LGCP by a standardized technique.
The patients were followed postoperatively using a strict program that included clinic visits, phone calls and social media communication. The main components of the follow up were
- Morbidity
- Weight loss
- Changes in co-morbid disease
- Patient satisfaction
Results: The participants were mostly females (42/53), with mean BMI 39.1 ± 0.19 kg/m², mean age 33.7.4 ± 1.29 years. Postoperative follow up was complete in 45 patients and partial in 8 patients. Seven patients suffered from transient nausea and vomiting that lasted for one week and managed conservatively. Six patients complained from hair loss. The mean total body weight loss was 25% ± 4.5 after 6 month. No revisions and no re-operations were needed in this series. Patient satisfaction was in the range of 94%. Improvement in the management of co morbidities occurred in 7 patients (14.8%).
Disucssion: LGCP is a bariatric procedure that requires no resection or bypass of the gastrointestinal tract. No staplers are needed, therefore the cost of the procdrure is significantly reduced. The procedure takes a longer time to perfom and needs special skills, yet for BMI belwow 4o kg/m² the excess body weight loss postoperatiely is satisfactory. Patients do not require extensive dietary supplements postoperatively. The down side is that the changes in comorbidities are not as high as other bariatric procedures.
Conclusion: LGCP is good option for morbidly obese patients with BMI below 40 with close postoperative monitoring. The low cost is an added advantage, especially in low-income countries.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94046
Program Number: P193
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster