Case Report: Comparative Analysis of Surgical Treatments with Sleeve Gastrectomy in Recurrent Cascade Stomach

<ns3:p>Introduction Cascade stomach (CS) or “cup and spill,” is an anatomical and functional deformity where the gastric fundus folds dorsally toward the corpus, creating biloculation. Surgical treatments for CS include gastropexy, sleeve gastrectomy, and Nissen fundoplication, however, standardized guidelines are lacking. Case Presentation A 58-year-old male presented to our hospital with a 20 years history of rapid feeling of full and abdominal discomfort after eating. He had undergone Roux-en-Y gastrojejunostomy in 2000, with a recurrence of symptoms shortly thereafter. Imaging revealed biloculation of the stomach with ventral flexion of the fundus, and endoscopy revealed the absence of the stomach ridge. A diagnosis of ventral gastric cascade was made, and the patient was successfully treated with proximal sleeve gastrectomy. Methods A systematic search was conducted in PubMed, Scopus, ProQuest, Cochrane Library, EBSCOhost, and Google Scholar identified relevant studies. Articles were selected according to specific inclusion and exclusion criteria, resulting in the identification of five eligible studies. Results Sleeve gastrectomy demonstrated effective in alleviating symptoms by addressing biloculation and preventing axial rotation of the stomach. Comparative analyses revealed its advantages over gastropexy and gastrogastric anastomosis, offering long-term symptom resolution with minimal complications. Clinical Discussion Two studies highlighted the benefits of gastric sleeve resection in addressing non-functional gastric segments and preventing volvulus. Two other studies demonstrated that fundoplication could alleviate gastroesophageal reflux disease (GERD)-related symptoms. These cases emphasize the importance of tailoring surgical techniques to individual patient needs and balancing symptom relief and complication risks. Conclusion Sleeve gastrectomy is a promising option for CS, offering symptom resolution in recurrent cases. Further comparative studies are essential to establish the optimal surgical approaches and long-term outcomes.</ns3:p>