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Laparoscopic Roux-en-Y gastric bypass in patients with BMI <50: a prospective randomized trial comparing short and long limb lengths.
Obes Surg. 2005 Jan; 15(1):51-7.OS

Abstract

BACKGROUND

It has been shown that long limb gastric bypass in the super-obese (BMI >50) results in increased weight loss in comparison with conventional gastric bypass. The purpose of this study was to compare the effect of short and long limb lengths in patients with BMI<50.

METHODS

48 patients with BMI <50 (46 females / 2 males, mean age 35+/-9.6 years) were prospectively randomized to either a short limb (biliopancreatic limb = 50 cm, alimentary limb = 100 cm) or long limb (biliopancreatic limb = 100 cm, alimentary limb = 150 cm) laparoscopic Roux-en-Y gastric bypass (LRYGBP). In all patients, a 25-mm EEA was used to fashion the gastrojejunostomy and the Roux limb was positioned in an antecolic, antegastric location. Limb lengths were precisely measured in all cases.

RESULTS

There was no difference in demographic data, preoperative BMI, presence of co-morbidities, or duration of surgery. The overall complication rate was not different between the 2 groups; however, the incidence of internal hernias was significantly higher in the long limb group (0 vs 4, P=0.029). The length of hospital stay was longer for the short limb group compared to the long limb group (3.1 vs 2.2 respectively, P=0.004). When comparing the short limb to the long limb patients, the BMI decreased equally in both groups at the following time intervals: preoperative (44.6 vs 44.9), 3 weeks (40.3 vs 40.9), 3 months (35.5 vs 35.2), 6 months (31.2 vs 31.8), and 12 months (27.7 vs 28.3). There were no significant nutritional deficiencies in either group.

CONCLUSIONS

In patients with BMI <50 undergoing LRYGBP, increasing the length of the Roux limb does not improve weight loss and may lead to a higher incidence of internal hernias.

Authors+Show Affiliations

Department of Surgery, Section of Endocrine Surgery, College of Physicians and Surgeons of Columbia University, Columbia University Medical Center, New York, NY, USA. wbi2102@columbia.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15760498

Citation

Inabnet, William B., et al. "Laparoscopic Roux-en-Y Gastric Bypass in Patients With BMI <50: a Prospective Randomized Trial Comparing Short and Long Limb Lengths." Obesity Surgery, vol. 15, no. 1, 2005, pp. 51-7.
Inabnet WB, Quinn T, Gagner M, et al. Laparoscopic Roux-en-Y gastric bypass in patients with BMI <50: a prospective randomized trial comparing short and long limb lengths. Obes Surg. 2005;15(1):51-7.
Inabnet, W. B., Quinn, T., Gagner, M., Urban, M., & Pomp, A. (2005). Laparoscopic Roux-en-Y gastric bypass in patients with BMI <50: a prospective randomized trial comparing short and long limb lengths. Obesity Surgery, 15(1), 51-7.
Inabnet WB, et al. Laparoscopic Roux-en-Y Gastric Bypass in Patients With BMI <50: a Prospective Randomized Trial Comparing Short and Long Limb Lengths. Obes Surg. 2005;15(1):51-7. PubMed PMID: 15760498.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic Roux-en-Y gastric bypass in patients with BMI <50: a prospective randomized trial comparing short and long limb lengths. AU - Inabnet,William B, AU - Quinn,Theresa, AU - Gagner,Michel, AU - Urban,Meredith, AU - Pomp,Alfons, PY - 2005/3/12/pubmed PY - 2005/4/6/medline PY - 2005/3/12/entrez SP - 51 EP - 7 JF - Obesity surgery JO - Obes Surg VL - 15 IS - 1 N2 - BACKGROUND: It has been shown that long limb gastric bypass in the super-obese (BMI >50) results in increased weight loss in comparison with conventional gastric bypass. The purpose of this study was to compare the effect of short and long limb lengths in patients with BMI<50. METHODS: 48 patients with BMI <50 (46 females / 2 males, mean age 35+/-9.6 years) were prospectively randomized to either a short limb (biliopancreatic limb = 50 cm, alimentary limb = 100 cm) or long limb (biliopancreatic limb = 100 cm, alimentary limb = 150 cm) laparoscopic Roux-en-Y gastric bypass (LRYGBP). In all patients, a 25-mm EEA was used to fashion the gastrojejunostomy and the Roux limb was positioned in an antecolic, antegastric location. Limb lengths were precisely measured in all cases. RESULTS: There was no difference in demographic data, preoperative BMI, presence of co-morbidities, or duration of surgery. The overall complication rate was not different between the 2 groups; however, the incidence of internal hernias was significantly higher in the long limb group (0 vs 4, P=0.029). The length of hospital stay was longer for the short limb group compared to the long limb group (3.1 vs 2.2 respectively, P=0.004). When comparing the short limb to the long limb patients, the BMI decreased equally in both groups at the following time intervals: preoperative (44.6 vs 44.9), 3 weeks (40.3 vs 40.9), 3 months (35.5 vs 35.2), 6 months (31.2 vs 31.8), and 12 months (27.7 vs 28.3). There were no significant nutritional deficiencies in either group. CONCLUSIONS: In patients with BMI <50 undergoing LRYGBP, increasing the length of the Roux limb does not improve weight loss and may lead to a higher incidence of internal hernias. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/15760498/Laparoscopic_Roux_en_Y_gastric_bypass_in_patients_with_BMI_<50:_a_prospective_randomized_trial_comparing_short_and_long_limb_lengths_ L2 - https://dx.doi.org/10.1381/0960892052993468 DB - PRIME DP - Unbound Medicine ER -