Gastric greater curvature plication combined with Nissen fundoplication compared to sleeve gastrectomy in patients with obesity and animal model

Abstract Background Gastric greater curvature plication combined with Nissen fundoplication (GGCP + Nissen) has been previously performed, but its efficacy remains uncertain. Methods A single-center retrospective review was conducted on patients with obesity who underwent GGCP + Nissen or sleeve gas...

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Main Authors: Chong Cao, Bo Xu, Yu Wang, Yikai Shao, Qiwei Shen, Xiaojian Fu, Rong Hua, Qiyuan Yao
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-025-02960-3
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author Chong Cao
Bo Xu
Yu Wang
Yikai Shao
Qiwei Shen
Xiaojian Fu
Rong Hua
Qiyuan Yao
author_facet Chong Cao
Bo Xu
Yu Wang
Yikai Shao
Qiwei Shen
Xiaojian Fu
Rong Hua
Qiyuan Yao
author_sort Chong Cao
collection DOAJ
description Abstract Background Gastric greater curvature plication combined with Nissen fundoplication (GGCP + Nissen) has been previously performed, but its efficacy remains uncertain. Methods A single-center retrospective review was conducted on patients with obesity who underwent GGCP + Nissen or sleeve gastrectomy (SG) between January 2016 and December 2022. Both groups were matched for age, gender, and baseline BMI. In the animal experiments, GGCP + Nissen, SG, and sham procedures were performed on Goto-Kakizaki rats, a model of normal-weight rats with T2DM. Results A total of 75 patients were included in this study, of whom 35 underwent GGCP + Nissen, and 40 underwent SG. Both groups were matched for age, gender, and baseline BMI. The percent total weight loss (%TWL) in the GGCP + Nissen and SG groups were 16.38 ± 3.69 and 25.05 ± 7.24 at 6 months (P < 0.05), 16.40 ± 4.96 and 26.85 ± 9.13 at 12 months (P < 0.05), and 12.46 ± 5.90 and 24.57 ± 8.61 at 24 months (P < 0.05), respectively. However, all 8 patients with preoperative reflux in the GGCP + Nissen group achieved complete resolution of symptoms postoperatively, whereas in the SG group, 10 patients developed new-onset reflux at 1 month, with 4 continuing to experience persistent symptoms at 24-month follow-up. In the animal experiments, both GGCP + Nissen and SG induced significant weight loss and improved glucose tolerance, with rats showing increased insulin sensitivity and secretion. However, the SG group performed better than the GGCP + Nissen group in terms of both weight loss and improvement of glucose tolerance. Conclusions GGCP + Nissen was inferior to SG both in weight loss and improvement of glucose tolerance, although GGCP + Nissen could lead a substantial weight loss and improve GERD efficiently.
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spelling doaj-art-47c9af3eae024bdfa46e8008d0a2c0d02025-08-20T02:39:02ZengBMCBMC Surgery1471-24822025-05-012511910.1186/s12893-025-02960-3Gastric greater curvature plication combined with Nissen fundoplication compared to sleeve gastrectomy in patients with obesity and animal modelChong Cao0Bo Xu1Yu Wang2Yikai Shao3Qiwei Shen4Xiaojian Fu5Rong Hua6Qiyuan Yao7Center for Obesity and Hernia Surgery, Department of General Surgery, Huashan Hospital, Fudan UniversityCenter for Obesity and Hernia Surgery, Department of General Surgery, Huashan Hospital, Fudan UniversityDepartment of Nursing, Huashan Hospital, Fudan UniversityCenter for Obesity and Hernia Surgery, Department of General Surgery, Huashan Hospital, Fudan UniversityCenter for Obesity and Hernia Surgery, Department of General Surgery, Huashan Hospital, Fudan UniversityCenter for Obesity and Hernia Surgery, Department of General Surgery, Huashan Hospital, Fudan UniversityCenter for Obesity and Hernia Surgery, Department of General Surgery, Huashan Hospital, Fudan UniversityCenter for Obesity and Hernia Surgery, Department of General Surgery, Huashan Hospital, Fudan UniversityAbstract Background Gastric greater curvature plication combined with Nissen fundoplication (GGCP + Nissen) has been previously performed, but its efficacy remains uncertain. Methods A single-center retrospective review was conducted on patients with obesity who underwent GGCP + Nissen or sleeve gastrectomy (SG) between January 2016 and December 2022. Both groups were matched for age, gender, and baseline BMI. In the animal experiments, GGCP + Nissen, SG, and sham procedures were performed on Goto-Kakizaki rats, a model of normal-weight rats with T2DM. Results A total of 75 patients were included in this study, of whom 35 underwent GGCP + Nissen, and 40 underwent SG. Both groups were matched for age, gender, and baseline BMI. The percent total weight loss (%TWL) in the GGCP + Nissen and SG groups were 16.38 ± 3.69 and 25.05 ± 7.24 at 6 months (P < 0.05), 16.40 ± 4.96 and 26.85 ± 9.13 at 12 months (P < 0.05), and 12.46 ± 5.90 and 24.57 ± 8.61 at 24 months (P < 0.05), respectively. However, all 8 patients with preoperative reflux in the GGCP + Nissen group achieved complete resolution of symptoms postoperatively, whereas in the SG group, 10 patients developed new-onset reflux at 1 month, with 4 continuing to experience persistent symptoms at 24-month follow-up. In the animal experiments, both GGCP + Nissen and SG induced significant weight loss and improved glucose tolerance, with rats showing increased insulin sensitivity and secretion. However, the SG group performed better than the GGCP + Nissen group in terms of both weight loss and improvement of glucose tolerance. Conclusions GGCP + Nissen was inferior to SG both in weight loss and improvement of glucose tolerance, although GGCP + Nissen could lead a substantial weight loss and improve GERD efficiently.https://doi.org/10.1186/s12893-025-02960-3Gastric greater curvature plicationNissen fundoplicationSleeve gastrectomyBariatric surgeryObesity
spellingShingle Chong Cao
Bo Xu
Yu Wang
Yikai Shao
Qiwei Shen
Xiaojian Fu
Rong Hua
Qiyuan Yao
Gastric greater curvature plication combined with Nissen fundoplication compared to sleeve gastrectomy in patients with obesity and animal model
BMC Surgery
Gastric greater curvature plication
Nissen fundoplication
Sleeve gastrectomy
Bariatric surgery
Obesity
title Gastric greater curvature plication combined with Nissen fundoplication compared to sleeve gastrectomy in patients with obesity and animal model
title_full Gastric greater curvature plication combined with Nissen fundoplication compared to sleeve gastrectomy in patients with obesity and animal model
title_fullStr Gastric greater curvature plication combined with Nissen fundoplication compared to sleeve gastrectomy in patients with obesity and animal model
title_full_unstemmed Gastric greater curvature plication combined with Nissen fundoplication compared to sleeve gastrectomy in patients with obesity and animal model
title_short Gastric greater curvature plication combined with Nissen fundoplication compared to sleeve gastrectomy in patients with obesity and animal model
title_sort gastric greater curvature plication combined with nissen fundoplication compared to sleeve gastrectomy in patients with obesity and animal model
topic Gastric greater curvature plication
Nissen fundoplication
Sleeve gastrectomy
Bariatric surgery
Obesity
url https://doi.org/10.1186/s12893-025-02960-3
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