INITIAL EXPERIENCE WITH THE SURGICAL-MANAGEMENT OF MORBID-OBESITY ASSOCIATED WITH SYMPTOMATIC GASTROESOPHAGEAL REFLUX - A COMPARISON BETWEEN GASTROPLASTY ALONE AND GASTROPLASTY WITH ANTERIOR FUNDOPLICATION

The optimal management of patients with morbid obesity and gastro-esop hageal reflux disease (GERD) remains an unresolved issue. We have perf ormed a vertical banded gastroplasty combined with an anterior fundopl ication (VBG + AF) in 28 selected morbidly obese patients with moderat e or severe heartburn. The patients who underwent VBG + AF are compare d to patients who had similar heartburn symptoms and underwent gastrop lasty alone during this period. In the VBG + AF group there were two t reatment failures (7%). In the gastroplasty group there were 63 patien ts with 15 treatment failures (24%). These differences were independen t of demographic and weight loss variables. These results suggest that VBG + AF may provide a superior option for the management of morbidly obese patients with GERD.