{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T18:57:55Z","timestamp":1762196275236,"version":"build-2065373602"},"reference-count":55,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Laparoscopic sleeve gastrectomy (SG) is the most performed bariatric procedure, providing effective weight loss and comorbidity improvement. However, its association with new-onset or worsening gastroesophageal reflux disease (GERD) remains a limitation. To address this, fundoplication sleeve gastrectomy (FSG) has been proposed by combining SG with an anti-reflux procedure. This systematic review and meta-analysis evaluates the efficacy and safety of FSG in patients with severe obesity. Methods: PubMed, Scopus, and Web of Science were systematically searched up to December 2023. Eligible studies included adults with BMI \u2265 40 kg\/m2 or \u226535 kg\/m2 with comorbidities undergoing FSG or SG with \u226512 months of follow-up. Random-effects meta-analysis compared FSG and SG in terms of weight loss, postoperative GERD, and complications. Results: Twelve studies (n = 543) were included; five contributed to the meta-analysis. Pooled analysis showed no significant difference in percentage of excess weight loss (%EWL) between FSG and SG (Hedges\u2019 g = \u22120.11; 95% CI: \u22120.99\u20130.76; I2 = 86%), and similar %TWL outcomes (Hedges\u2019 g = \u22120.28; 95% CI: \u22120.70\u20130.13). FSG demonstrated a significantly lower postoperative GERD prevalence (RR = 0.08; 95% CI: 0.01\u20130.47) and greater GERD resolution (RR = 1.86; 95% CI: 0.80\u20134.20), but higher complication (RR = 2.95; 95% CI: 1.02\u20138.50) and reoperation rates (RR = 4.39; 95% CI: 1.47\u201313.12). Conclusions: FSG achieves weight loss comparable to SG and may reduce postoperative GERD prevalence, but carries an increased complication and reoperation risk. Further randomized trials with standardized GERD definitions and longer follow-up are required.<\/jats:p>","DOI":"10.3390\/jcm14217723","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T05:28:43Z","timestamp":1761888523000},"page":"7723","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Fundoplication Sleeve Gastrectomy in Obesity and GERD: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0452-4552","authenticated-orcid":false,"given":"Filipe","family":"Amorim-Cruz","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Porto\u2014Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Surgery Department, S\u00e3o Jo\u00e3o University Medical Center, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"given":"Diogo","family":"Fernandes Lopes","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto\u2014Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1277-3401","authenticated-orcid":false,"given":"Bernardo","family":"Sousa-Pinto","sequence":"additional","affiliation":[{"name":"MEDCIDS\u2014Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, Rua Dr. Pl\u00e1cido da Costa, 4200-450 Porto, Portugal"},{"name":"CINTESIS\u2014Center for Health Technologies and Services Research, University of Porto, Rua Dr. Pl\u00e1cido da Costa, 4200-450 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6176-5654","authenticated-orcid":false,"given":"Hugo","family":"Santos-Sousa","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto\u2014Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Surgery Department, S\u00e3o Jo\u00e3o University Medical Center, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"},{"name":"Obesity Integrated Responsibility Unit (CRI-O), S\u00e3o Jo\u00e3o University Medical Center, Alameda Prof. Hern\u00e2ni Monteiro, 4200-319 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2279","DOI":"10.1007\/s11695-017-2666-x","article-title":"Bariatric Surgery and Endoluminal Procedures: IFSO Worldwide Survey 2014","volume":"27","author":"Angrisani","year":"2017","journal-title":"Obes. 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