MODIFIED METHOD OF LAPAROSCOPIC LONGITUDINAL GASTRIC RESECTION IN SURGICAL TREATMENT OF PATIENTS WITH METABOLIC SYNDROME AGAINST THE BACKGROUND OF GASTROESOPHAGEAL REFLUX DISEASE

Obesity and metabolic syndrome represent significant risk factors for the development of cardiovascular diseases, which are statistically the leading cause of mortality [1]. This underscores the necessity of conducting scientific research on pathologies characterized by a comorbid course [2]. Purpose of the study: Development of a modified technique for laparoscopic longitudinal gastric resection in the surgical treatment of patients with metabolic syndrome complicated by gastroesophageal reflux disease. Materials and methods. The study is based on a double-cohort comparative analysis of two patient groups selected between 2020 and 2023. A total of 120 patients were included in the study. The control group comprised patients treated and examined in the Department of Surgery at the Multidisciplinary Clinic of the Tashkent Medical Academy from 2020 to 2021, while the main group included patients treated from 2022 to 2023. Results and their discussion. In the early postoperative period and during follow-up up to 30 days, there was a trend toward improvement in laboratory parameters characterizing the manifestations of metabolic syndrome. Fasting glycemia levels decreased, and laboratory indicators of dyslipidemia normalized. Moreover, the changes in these parameters on days 14–30 of the postoperative period became statistically significant compared to baseline values. Conclusions. The application of modified laparoscopic longitudinal gastric resection in patients with metabolic syndrome and concomitant gastroesophageal reflux disease led to improved long-term treatment outcomes. Specifically, the frequency of "excellent" results increased from 11.1% to 23.3% of cases (a 2.1-fold increase), while "good" results increased from 22.2% to 50% (a 2.25-fold increase). Additionally, cases with "unsatisfactory" treatment outcomes were completely eliminated. The frequency of repeated hospitalizations decreased by 3.9 times, and the number of bed-days was reduced by 3 times. These findings indicate enhanced treatment efficacy, improved quality of life, and a reduction in the period of work incapacity.