Calibration of the Gastric Pouch in Laparoscopic Roux-en-Y Gastric Bypass: Does It Matter? The Influence on Weight Loss.

Autor: Reiber BMM; Department of Surgery, Red Cross Hospital Beverwijk, Vondellaan 13, 1942 LE, Beverwijk, The Netherlands. beata.reiber@slz.nl., Tenhagen M; Department of Surgery, Red Cross Hospital Beverwijk, Vondellaan 13, 1942 LE, Beverwijk, The Netherlands., Hunfeld MAJM; Department of Surgery, Red Cross Hospital Beverwijk, Vondellaan 13, 1942 LE, Beverwijk, The Netherlands., Cense HA; Department of Surgery, Red Cross Hospital Beverwijk, Vondellaan 13, 1942 LE, Beverwijk, The Netherlands., Demirkiran A; Department of Surgery, Red Cross Hospital Beverwijk, Vondellaan 13, 1942 LE, Beverwijk, The Netherlands.
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2018 Nov; Vol. 28 (11), pp. 3400-3404.
DOI: 10.1007/s11695-018-3352-3
Abstrakt: Purpose: To determine the effect of an orogastric tube for calibration of the gastric pouch on percentage excess weight loss (%EWL) and percentage total weight loss (%TWL) after laparoscopic Roux-en-Y gastric bypass (LRYGB).
Material and Methods: A retrospective case-matched control study in 132 patients. Group A (a 40 French orogastric tube was used to calibrate the gastric pouch) was compared to group B (no orogastric tube was used). All other surgical steps were identical in both groups. Postoperative %EWL and %TWL were recorded at 3, 6, 9, 12, and 24 months postoperatively.
Results: Baseline characteristics and comorbidities were similar for both groups; a mean age of 43.6 years, 84% of the patients were female and mean initial BMI was 44 kg/m 2 . At 24 months, 9% of the patients were lost to follow-up. At 1-year follow-up, %EWL and %TWL were 80% and 33.3% in group A versus 70% and 28.6% in group B with p = 0.013 and p = 0.007 respectively. At 2 years, EWL% and %TWL were 79.5% and 32.8% in group A and 67.18% and 28.1% in group B with a p value of 0.019 and 0.001 respectively. The use of a calibration tube, initial BMI, and age predicted the %TWL best with R squared at 30.7%.
Conclusion: The use of a calibration tube for creating the gastric pouch may lead to a higher %EWL and %TWL at 2-year follow-up. The standardization of the technique for LRYGB is desirable to achieve the maximum success rate in the surgical therapy of morbid obesity.
Databáze: MEDLINE
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