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The Nissen-Sleeve (N-Sleeve): Results of a Cohort Study

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Abstract

Background

The Montpellier bariatric team has recently proposed some technical alternatives to decrease the rate of gastroesophageal reflux disease (GERD) after bariatric surgery and also to offer patients an alternative in case of contraindication to Roux-en-Y gastric bypass (RYGBP): the Nissen-Sleeve (N-Sleeve).

Objectives

We present here the results from a cohort of patients that underwent an operation with this newly designed anti-reflux bariatric procedure N-Sleeve: Nissen valve added to a standard SG.

Methods

Data from a prospective, observational, and monocentric cohort. All consecutive patients presenting to the bariatric surgery department for a laparoscopic sleeve gastrectomy between 2016 and 2018 with GERD were included in the study. The fundus was stapled with a margin from the valve, and the valve was created with tissue at a distance from the greater curvature so as to avoid a double layer stapling of the stomach.

Results

A total of 70 patients were included in the study. Ninety percent of the cohort presented with a hiatal hernia at the time of surgery. No mortality was observed during the follow-up period. Concerning GERD, 76% of all patients had preoperative esophageal syndromes, whereas 21% were asymptomatic with associated esophagitis. Grade A–C esophagitis was present in 99% of the cohort, but no Barrett’s esophagus was present. Fifty-six (80%) patients used PPIs regularly. At 1 year of follow-up, one patient was still symptomatic.

Conclusions

Comparative trials remain necessary between N-Sleeve and standard bariatric procedures to refine the specific indications of each of them and determine the eventual role of the N-Sleeve.

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Authors and Affiliations

  1. Department of Bariatric Surgery, Archet II Hospital, University of Nice-Sophia-Antipolis, Nice, France

    Imed Ben Amor, Vincent Casanova & Jean Gugenheim

  2. Université nice Sophia Antipolis, Nice, France

    Imed Ben Amor

  3. IRCAN; Unité INSERM 1081, Nice, France

    Imed Ben Amor

  4. Department of Gastroenterology, Archet II Hospital, University of Nice-Sophia-Antipolis, Nice, France

    Geoffroy Vanbiervliet

  5. Department of Digestive Surgery, Archet II Hospital, University of Nice-Sophia-Antipolis, Nice, France

    Jean Marc Bereder

  6. Department of Digestive Surgery, Casablanca, Morocco

    Richard Habitan

  7. Department of Digestive Surgery, CHU Félix Guyon, La réunion, Saint Denis, Paris, France

    Radwan Kassir

Authors
  1. Imed Ben Amor
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  2. Vincent Casanova
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  3. Geoffroy Vanbiervliet
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  4. Jean Marc Bereder
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  7. Jean Gugenheim
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Correspondence to Imed Ben Amor.

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The authors declare that they have no conflict of interest.

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“Informed consent was obtained from all individual participants included in the study.”

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Amor, I.B., Casanova, V., Vanbiervliet, G. et al. The Nissen-Sleeve (N-Sleeve): Results of a Cohort Study. OBES SURG 30, 3267–3272 (2020). https://doi.org/10.1007/s11695-020-04469-5

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  • DOI: https://doi.org/10.1007/s11695-020-04469-5

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