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Abstract Background: Obesity is a worldwide pandemic and one of the most serious public health issues. Over 640 million obese people are estimated to exist in the world today. A BMI of ≥ 40 is morbid obesity. In a morbidly obese and super obese population, bariatric surgeons have particular challenges, and more often than not technical problems associated with super obese patients are more complex in surgical navigation. Objective: To compare between laparoscopic sleeve gastrectomy (LSG) with cruroplasty and laparoscopic Roux-en-Y gastric bypass (LRNYGB) in morbid obese patients with gastro-esophageal reflux as regard weight loss and gastroesophageal reflux disease (GERD) symptoms improvement with 1 year follow up after operation. Patients and Methods: This is a prospective randomized clinical trial study conducted on those who are diagnosed as a morbidly obese patients with gastroesophageal reflux disease grade A and B by endoscopy according to their BMI (>40) or >35 with one or two of obesity related co-morbidities such as diabetes mellitus, hypertension, dyslipidemia, osteoarthritis, infertility, and severe sleep apnea). Results: There was no statistically significant difference found between the two studied groups regarding EBW loss percentage at 1 month while there was statistically significant increase in the EBW loss percentage at 3 month, 6 month and at 1 year (59.98 ± 3.43 vs 64.44 ± 3.15) in roux ny gastric bypass than sleeve with cururoplasty group That there was no statistically significant difference found between the two studied groups regarding GERD severity at 1 month while there was statistically significant difference found between the two studied groups regarding GERD severity at 3 months, 6 months and 1 year, and the improvement from reflux symptoms was higher in roux ny group than sleeve group with cruroplasty at 1 month, 3 months, 6 months and 1 year Conclusion: Roux-en-Y gastric bypass is highly effective in addressing GERD and morbid obesity as it showing higher significant weight loss and GERD improvement than Sleeve gastrectomy with cruroplasty in morbid obesity patient. However, Sleeve gastrectomy with cruroplasty showing good results regarding weight loss and GERD symptoms control |