LAPAROSCOPIC GASTRIC PLICATION COMPARED WITH SLEEVE GASTRECTOMY FOR MORBID OBESITY : A PROSPECTIVE RANDOMIZED STUDY

Background: Laparoscopic sleeve gastrectomy (LSG) involves resection of a significant portion of the stomach. Laparoscopic gastric plication (LGP) is a relatively alternative procedure similar to LSG, but without the need for gastric resection and low financial coast. Patients and methods: Fifty two patients fulfilled the National Institutes of Health criteria and were assigned randomly toreceive either LGP (n = 26)19 women and 7 men; mean age 40.15? 7.35 (21 ? 48) years and a mean BMI 46.96?4.30 kg/m2 or LSG (n = 26) 17 women and 9 men; mean age 39.73? 8.53 (20?50) years and a mean BMI 46.23?4.21 kg/m2 by a block randomization method. Patients were studied in terms of postoperative weight loss, complications. Change of HbA1c and hypertension. Results: All procedures were completed laparoscopically. Follow-up was 12 months. The mean hospitalstay was 2.5 (3?6) days for both groups. Postoperative complications occurred in 2 cases of minor leak and3 cases of bleeding were detected after LSG and one case of bleeding and two cases of gastric stenosisfollowing LGP. All patients experienced postoperative excess weight loss which was significantly better in the LSG group in terms of the change inBMI (mean 19.04 compared with 14.72 in LGP) and reduction of HbA1c (mean 1.3 compared with 0.6 in LGP).The improvement in hypertension was not significant. Conclusion: LGP is feasible, safe, inexpensive and effective, but has an inferior weight-loss effect compared to LSG for morbidly obese patients with BMI above 40 kg/m2.