One-Year Outcomes of Sleeve-Dor Fundoplication for Obesity and Gastroesophageal Reflux Disease

Recent literature has highlighted an increased risk of de novo gastroesophageal reflux disease (GERD) and a higher incidence of Barrett's esophagus following sleeve gastrectomy (SG), raising concerns regarding the potential development of esophageal adenocarcinoma in this population. This study evaluates the Sleeve-Dor procedure, a modification of SG that incorporates an anterior 180° Dor fundoplication, as a protective strategy against these long-term complications in patients with obesity. A standard SG was performed laparoscopically, leaving a small redundancy of the gastric fundus to create a 180° anterior wrap anchored to the right crus without dissecting the hiatus. This configuration provides partial fundoplication designed to prevent or alleviate reflux symptoms following SG. Ethical approval for data collection and analysis was obtained in accordance with the Declaration of Helsinki, and all patients provided informed consent. The Sleeve-Dor procedure demonstrated a favorable safety profile, effective reflux control, and satisfactory weight-loss outcomes over the follow-up period, with low morbidity and no increase in perioperative complications compared with conventional SG. These findings suggest that the Sleeve-Dor approach may represent a valuable surgical option for patients with obesity and pre-existing or potential reflux disease. By integrating a physiological anti-reflux mechanism into the SG framework, this technique may reduce the risk of postoperative GERD and Barrett's esophagus without compromising bariatric efficacy.