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The effect of residual gastric antrum size on the outcome of laparoscopic sleeve gastrectomy: a prospective randomized trial.
Surg Obes Relat Dis. 2015 Sep-Oct; 11(5):997-1003.SO

Abstract

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.

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Authors+Show Affiliations

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.

MeSH

AdultAge FactorsBody Mass IndexEgyptFemaleFollow-Up StudiesGastrectomyGastric StumpHumansLaparoscopyMaleMiddle AgedObesity, MorbidProspective StudiesPyloric AntrumQuality of LifeRisk AssessmentSex FactorsTime FactorsTreatment OutcomeWeight Loss

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

25638594

Citation

ElGeidie, Ahmed, et al. "The Effect of Residual Gastric Antrum Size On the Outcome of Laparoscopic Sleeve Gastrectomy: a Prospective Randomized Trial." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 11, no. 5, 2015, pp. 997-1003.
ElGeidie A, ElHemaly M, Hamdy E, et al. The effect of residual gastric antrum size on the outcome of laparoscopic sleeve gastrectomy: a prospective randomized trial. Surg Obes Relat Dis. 2015;11(5):997-1003.
ElGeidie, A., ElHemaly, M., Hamdy, E., El Sorogy, M., AbdelGawad, M., & GadElHak, N. (2015). The effect of residual gastric antrum size on the outcome of laparoscopic sleeve gastrectomy: a prospective randomized trial. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 11(5), 997-1003. https://doi.org/10.1016/j.soard.2014.12.025
ElGeidie A, et al. The Effect of Residual Gastric Antrum Size On the Outcome of Laparoscopic Sleeve Gastrectomy: a Prospective Randomized Trial. Surg Obes Relat Dis. 2015 Sep-Oct;11(5):997-1003. PubMed PMID: 25638594.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of residual gastric antrum size on the outcome of laparoscopic sleeve gastrectomy: a prospective randomized trial. AU - ElGeidie,Ahmed, AU - ElHemaly,Mohamed, AU - Hamdy,Emad, AU - El Sorogy,Mohamed, AU - AbdelGawad,Mohamed, AU - GadElHak,Nabil, Y1 - 2014/12/29/ PY - 2014/10/29/received PY - 2014/12/02/revised PY - 2014/12/19/accepted PY - 2015/2/2/entrez PY - 2015/2/2/pubmed PY - 2016/9/20/medline KW - Bariatric surgery KW - Morbid obesity KW - Residual antrum KW - Sleeve gastrectomy SP - 997 EP - 1003 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 11 IS - 5 N2 - 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. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/25638594/The_effect_of_residual_gastric_antrum_size_on_the_outcome_of_laparoscopic_sleeve_gastrectomy:_a_prospective_randomized_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(14)00507-3 DB - PRIME DP - Unbound Medicine ER -