BACKGROUND: Laparoscopic greater curvature plication (LGCP) is an innovative restrictive technique designed to reduce gastric volume by plication at the region of greater curvature. The long-term efficacy, safety, and the metabolic effects of this procedure are the subject of this study. METHODS: One hundred twenty-seven patients were enrolled; 84 underwent laparoscopic sleeve gastrectomy (LSG) and 43, LGCP. LSG and LGCP were then compared during long-term follow-ups in terms of glycemic control, hormone and lipid secretion, and changes in body composition. Measured parameters included serum glucose, triglycerides, high- and low-density lipoprotein cholesterol, testosterone, estradiol, leptin, adiponectin, ghrelin, fatmass, and lean body mass. RESULTS: Significant weight-loss and a reduced body composition resulted from either procedure vs. baseline (i.e., pre-surgery), with levels of fasting glucose and glycated hemoglobin also showing statistically significant reductions (at 3 and 18 months for either surgery). Intergroup comparisons for glycemic parameters yielded no statistically significant differences. However, a dramatic reduction in ghrelin was detected following LSG, falling from pre-surgery levels of 140.7 to 69.6 ng/L by 6 months (P < 0.001). Subsequently, ghrelin levels increased, reaching 107.8 ng/L by month 12. Conversely, after LGCP, a statistically significant increase in ghrelin was seen, rising from 130.0 ng/L before surgery to 169.0 ng/L by month 12, followed by a slow decline. CONCLUSIONS: Good metabolic outcomes were obtained following LGCP, which might be mediated via altered glucose metabolism and GI hormones. Nevertheless, this method is less effective than LSG, possibly due to its preservation of the entire stomach, including secretory regions.

• Klíčová slova
• Ghrelin, Hormonal changes, Laparoscopic greater curvature plication, Metabolic surgery, Sleeve gastrectomy,
• MeSH
• dospělí MeSH
• gastrektomie metody   rehabilitace   MeSH
• gastroplastika metody   rehabilitace   MeSH
• ghrelin metabolismus   MeSH
• glykovaný hemoglobin metabolismus   MeSH
• hmotnostní úbytek fyziologie   MeSH
• krevní glukóza metabolismus   MeSH
• laparoskopie metody   rehabilitace   MeSH
• lidé středního věku MeSH
• lidé MeSH
• metabolom * MeSH
• morbidní obezita metabolismus   chirurgie   MeSH
• následné studie MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• Názvy látek
• ghrelin MeSH
• glykovaný hemoglobin MeSH
• krevní glukóza MeSH