Abstract
INTRODUCTION: Sleeve gastrectomy (SG) is a first-line bariatric procedure but may exacerbate gastroesophageal reflux disease (GERD) symptoms in obese patients. To mitigate this critical limitation, we developed a novel sleeve-fundoplication without gastric resection (SG-F) and investigated its efficacy and safety in a rat model of diet-induced obesity. METHODS: A randomized controlled trial was conducted in twenty-four 8-week-old male SD obese rats, randomly assigned to the SG group (n = 12) or the SG-F group (n = 12). Postoperative complications (mortality, bleeding, GERD) and body weight changes were monitored for 6 weeks. The primary endpoint was the 6-week body weight change trajectory, and the secondary endpoint was postoperative GERD incidence. RESULTS: No statistically significant differences were observed in postoperative mortality or bleeding rates between the two groups. The incidence of postoperative GERD was significantly lower in the SG-F group than in the SG group (0% vs. 41.7%; P < 0.05; RR: 0.1, 95% CI: 0.01-0.79). A significant between-group difference in body weight was noted at 4 weeks postoperatively (SG-F: 473.4 ± 18.5 g vs. SG: 513.6 ± 21.3 g; P < 0.05; MD: -40.2 g, 95% CI: -65.1 to -15.3 g), while the overall 6-week weight loss effect was comparable between the two procedures (P = 0.307). CONCLUSION: SG-F achieves weight loss efficacy comparable to conventional SG without gastric resection, while suggesting improved anti-reflux protection and maintaining similar safety profiles in terms of mortality and bleeding. This novel procedure represents a promising alternative bariatric option for obese patients with GERD, avoiding the need for gastric tissue excision.