To investigate the preventive effect of laparoscopic sleeve gastrectomy (LSG) combined with intraoperative sharp His angle reconstruction (LSG-His) on postoperative gastroesophageal reflux disease (GERD) in obese patients.

A retrospective analysis was conducted on clinical data of 58 obese patients who underwent surgery at Bazhou People’s Hospital from January 2021 to December 2023. Patients were divided into LSG group (n=33) and LSG-His group (n=25) according to the surgical procedure. Univariate analysis (independent sample t-test, χ² test) was used to compare perioperative indicators (operation time, intraoperative blood loss, postoperative hospital stay), postoperative complications, weight loss outcomes at 12 months postoperatively, and incidence of GERD between the two groups. Multivariate logistic regression was performed to identify independent influencing factors for GERD.

The incidence of postoperative GERD in the LSG-His group was 24.0% (6/25), which was significantly lower than that in the LSG group (44.0%, 14/33; χ²=4.211, P=0.048). The LSG-His group had a shorter postoperative hospital stay than the LSG group [(4.1±0.5) days vs (4.6±0.7) days, t=2.350, P=0.032]. There were no statistically significant differences between the two groups in terms of percentage of excess weight loss at 12 months postoperatively [(47.2%±6.3%) vs (46.8%±6.1%)] or overall complication rate (16.00% vs 27.27%; P>0.05). Multivariate regression analysis showed that surgical procedure was an independent predictor of GERD (OR=0.414, 95%CI: 0.175–0.982, P=0.046).

The LSG-His procedure effectively reduces the risk of postoperative GERD in obese patients without compromising weight loss outcomes or increasing surgical risks.