The effect of residual gastric antrum size on the outcome of laparoscopic sleeve gastrectomy: a prospective randomized trial.

Autor:	ElGeidie A; Gastroenterology Surgical Center, Mansoura University, Egypt. Electronic address: Drarelgeidie68@hotmail.com., ElHemaly M; Gastroenterology Surgical Center, Mansoura University, Egypt., Hamdy E; Gastroenterology Surgical Center, Mansoura University, Egypt., El Sorogy M; Gastroenterology Surgical Center, Mansoura University, Egypt., AbdelGawad M; Gastroenterology Surgical Center, Mansoura University, Egypt., GadElHak N; Gastroenterology Surgical Center, Mansoura University, Egypt.
Jazyk:	angličtina
Zdroj:	Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery [Surg Obes Relat Dis] 2015 Sep-Oct; Vol. 11 (5), pp. 997-1003. Date of Electronic Publication: 2014 Dec 29.
DOI:	10.1016/j.soard.2014.12.025
Abstrakt:	Background: Laparoscopic sleeve gastrectomy (LSG) is gaining popularity worldwide as a definitive bariatric procedure. However, there are still some controversial issues associated with the technique, one of which is the size of the residual antrum. Objectives: The aim of this prospective randomized trial is to study the effect of the size of the residual gastric antrum on the outcome of LSG. Settings: University-affiliated hospital. Methods: Between November 2009 and August 2013, 113 morbidly obese patients submitted for LSG were randomized into 2 groups, namely antral preserving-LSG (AP-LSG) and antral resecting-LSG (AR-LSG), depending on the distance from the pylorus at which gastric division begins. In the AP-LSG group, the distance was 6 cm from the pylorus and included 58 patients, whereas the distance was 2 cm in the AR-LSG group and included 55 patients. The follow-up period was at least 12 months. Baseline and 6 and 12 month outcomes were analyzed including assessments of the percent excess weight lost (%EWL), reduction in BMI, morbidity, mortality, reoperations, quality of life, and co-morbidities. Results: Both groups were comparable regarding age, gender, body mass index (BMI), and co-morbidities. There was one 30-day mortality, and there was no significant difference in the complication rate or early reoperations between the 2 groups. Weight loss was significant in both groups at 6 and 12 months. At 12 months, weight loss was greater in the AR-LSG than in the AP-LSG group, but with was no significant difference between the 2 groups at 12 months (%EWL was 64.2% in the AP-LSG group and 67.6% in the AR-LSG group; p>.05). The resolution/improvement of co-morbidities, quality of life outcome and the overall prevalence of co-morbidities were similar. Conclusions: LSG with or without antral preservation produces significant weight loss after surgery. The 2 procedures are equally effective regarding %EWL, morbidity, quality of life, and amelioration of co-morbidities. (Copyright © 2015 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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